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Questionnaire for Children Claiming SSI Benefits - Paper Version

IC 9392 under ICR 202005-0960-005 · OMB 0960-0499.

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Other-Revised PRA Statement
Other-Revised PRA Statement
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Questionnaire for Children Claiming SSI Benefits - Paper Version
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 416.912(a)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-3881 BK Questionnaire for Children Claiming SSI Benefits SSA-3881-BK - Revised.pdf Yes No Fillable Printable
Other-Revised PRA Statement Revised PRA Statement.pdf Yes No Fillable Printable

Income Security General Retirement and Disability

 

81,250 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 81,250 0 0 -48,750 0 130,000
Annual IC Time Burden (Hours) 81,250 0 0 16,250 0 65,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Questionnaire for Children Claiming SSI Benefits - Current SSA-3881-BK - Current.pdf 09/08/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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