Addendum to the Supporting Statement 0960-0542

Addendum 0960-0542.doc

Function Report - Child (Birth to 1st Birthday, Age 1 to 3rd Birthday, Age 3 to 6th Birthday, Age 6 to 12th Birthday, Age 12 to 18th Birthday), 20 CFR 416.912 and 416.924a(a)(2)

Addendum to the Supporting Statement 0960-0542

OMB: 0960-0542

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Addendum to the Supporting Statement for

Function Reports – Child

Forms SSA-3375, 3376, 3377, 3378, and 3379

20 CFR 416.912 and 416.924a(a)(2)



OMB No. 0960-0542


Public Comment to 60-day Advance Federal Register Notice, 78 FR 17276, March 20, 2013

The commenter agrees with SSA’s estimated time of completion for the collection instruments, however, the commenter recommends SSA consider revising the forms to mirror State disability determination services (DDS)-created forms to increase efficiency and eliminate duplication of effort in collecting this information.


SSA Response

Due to limited resources, SSA is not currently revising the questions we ask on the Function Reports (Forms SSA-3375-BK through SSA-3379-BK). We will consider the various DDS-created forms the commenter mentions when we next update these forms.


Minor Revisions to the Collection Instrument

SSA's Office of the General Counsel is conducting a systematic review of SSA's Privacy Act Statements on agency forms. As a result, SSA is updating the Privacy Act Statement on this form.

File Typeapplication/msword
File TitleAddendum to the Supporting Statement for Form SSA-2528
AuthorNaomi Lebowitz
Last Modified By889123
File Modified2013-05-30
File Created2013-04-03

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