Evidence to Prove Dependency of a Child

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0206 can be found here:

Documents and Forms

Document Name Document Type
RI25-037_Form.pdf Instruction
RI25-037_Forms.pdf RI 25-37 Forms (Mark-ups) IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Evidence to Prove Dependency of a Child	Agency IC Tracking Number:

Is this a Common Form? Yes		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 5 CFR 843.401 5 CFR 831.671

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			RI25-037_Form.pdf		No		Printable Only

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title: OPM /Central-1	FR Citation: 73 FR 15013

Number of Respondents: 250	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	250	250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
RI 25-37 Forms (Mark-ups)	RI25-037_Forms.pdf	12/17/2008

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