Information Collection

Disability Report - Child (Internet)

IC 179519 under ICR 201906-0960-006 · OMB 0960-0577.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0577 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
i3820 screens (current).pdf eis.ba.ssa.gov/i3820	Other-Disability Report - Child (Int

IC Title:

Disability Report - Child (Internet)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 416.912

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Disability Report - Child (Internet)			i3820 screens (current).pdf	http://eis.ba.ssa.gov/i3820	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 176,572

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 8 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	176,572	57,108	119,464
Annual IC Time Burden (Hours)	353,144	114,216	238,928
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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