Information Collection

Function Report, Child (Birth to 1st, Age 1 to 3rd, Age 3 to 6th, Age 6 to 12th, Age 12 to 18th Birthday)

IC 9454 under ICR 200106-0960-006 · OMB 0960-0542.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0542 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Function Report, Child (Birth to 1st, Age 1 to 3rd, Age 3 to 6th, Age 6 to 12th, Age 12 to 18th Birthday)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	3379	No	No
Form	SSA-3375	No	No
Form	3376	No	No
Form	3377	No	No
Form	3378	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 750,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	750,000	250,000	500,000
Annual IC Time Burden (Hours)	250,000	83,333	166,667
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.