SSA-1372-BK (Domestic)--State/Local/Tribal Government

Advanced Notice of Termination of Child's Benefits, and Student's Statement Regarding School Attendance

OMB: 0960-0105

IC ID: 182786

Documents and Forms
Document Name
Document Type
Form
Other-Revised Paperwork Reduction Ac
Other-Revised Paperwork Reduction Ac
Form
IC Document
Information Collection (IC) Details

View Information Collection (IC)

SSA-1372-BK (Domestic)--State/Local/Tribal Government
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 404.350-404.352 20 CFR 404.367-404.368

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-1372-BK Advanced Notice of Termination of Child's Benefits SSA-1372-BK (revised).pdf No   Paper Only
Other-Revised Paperwork Reduction Act 0105 Privacy Act Statement (revised).docx No   Paper Only
Other-Revised Paperwork Reduction Act Statement PRA 0105.docx No   Paper Only

Income Security General Retirement and Disability

 

209,861 0
   
State, Local, and Tribal Governments
 
   0 %

  Requested 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 209,861 0 0 110,011 0 99,850
Annual IC Time Burden (Hours) 10,493 0 0 5,500 0 4,993
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Advance Notice of Termincaiton fo Child's Benefits (current) SSA-1372-BK (current).pdf 08/25/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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