Function Report - Adult

Function Report - Adult

OMB: 0960-0681

IC ID: 9735

Information Collection (IC) Details

View Information Collection (IC)

Function Report - Adult
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 404.1512 20 CFR 416.912

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction SSA-3373 Function Report -- Adult SSA-3373 Revised Version.pdf No   Paper Only
Form and Instruction SSA-3373 Function Report - Adult SSA-3373 - Fillable PDF Version.pdf www.socialsecurity.gov Yes No Fillable Printable

Income Security General Retirement and Disability

 

4,221,656 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 4,221,656 0 0 0 0 4,221,656
Annual IC Time Burden (Hours) 4,292,017 0 0 0 0 4,292,017
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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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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