Report of Adult Functioning-Employer

Report of Adult Functioning-Employer

OMB: 0960-0805

IC ID: 221156

Information Collection (IC) Details

View Information Collection (IC)

Report of Adult Functioning-Employer
 
No Modified
 
Mandatory
 
20 CFR 416.912 20 CFR 404.1512

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-3385-BK Report of Adult Functioning-Employer SSA-3385 - Revised.pdf Yes No Fillable Printable

Income Security General Retirement and Disability

 

3,601 0
   
Private Sector Farms, Businesses or other for-profits, Not-for-profit institutions
 
   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 3,601 0 0 -299 0 3,900
Annual IC Time Burden (Hours) 1,200 0 0 -100 0 1,300
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-3385-BK - Current SSA-3385 - Current.pdf 08/06/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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