Pain Report - Child

Pain Report - Child

OMB: 0960-0540

IC ID: 9452

Documents and Forms
Information Collection (IC) Details

View Information Collection (IC)

Pain Report - Child
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 416.912 20 CFR 404.512

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-3371-BK Pain Report-Child ssa-3371 (revised).pdf No   Paper Only

Income Security General Retirement and Disability

 

250,000 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 250,000 0 0 0 0 250,000
Annual IC Time Burden (Hours) 62,500 0 0 0 0 62,500
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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