Information Collection

Childhood Disability Evaluation Form

IC 9516 under ICR 200609-0960-009 · OMB 0960-0568.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-538 Childhood Disability Evaluation Form Childhood Disability Evaluation Form	Form and Instruction
SSA-538-F6 AeDIB Screens.pdf co.ba.ssa.gov/eForms/forms/formselector.htm	Other-AeDIB Version of the SSA-538-F
SSA-538 Childhood Disability Evaluation Form SSA-538-F6.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 416.924(g)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-AeDIB Version of the SSA-538-F6				http://co.ba.ssa.gov/eForms/forms/formselector.htm	Yes	Yes	Fillable Fileable Signable
Form and Instruction	SSA-538				No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 750,000

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 80 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	750,000	750,000
Annual IC Time Burden (Hours)	312,500	312,500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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

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