Information Collection

Childhood Disability Evaluation Form

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

Documents and Forms

Document Name Document Type
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

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Childhood Disability Evaluation Form	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:

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			SSA-538-F6 AeDIB Screens.pdf	http://co.ba.ssa.gov/eForms/forms/formselector.htm	Yes	Yes	Fillable Fileable Signable
Form and Instruction	SSA-538	Childhood Disability Evaluation Form	SSA-538-F6.pdf		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 %

	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

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.