Information Collection Request

Dependency Statements: Parent, Incapacitated Child Over Age 21, Full Time Student 21-22, Ward of a Court

ICR 202101-0730-001 · OMB 0730-0014 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form DD Form 137-3 Dependency Statements: Parent, Incapacitated Child Over Age 21, Full Time Student 21-22 Years of Age, and Ward of a Court Form and Instruction Removed Repair queued
Form DD-137-7 Dependency Statement - Ward of a Court Form and Instruction New Repair queued
Form DD-137-6 Dependency Statement - Full Time Student 21-22 Years of Age Form and Instruction New Missing upstream
Form DD-137-5 Dependency Statement - Incapacitated Child Over Age 21 Form and Instruction New Repair queued
Form DD-137-3 Dependency Statement - Parent Form and Instruction New Repair queued
0730-0014_SS-A_5.17.2021.docx Supporting Statement A Uploaded 2021-05-17 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
5649 Dependency Statements: Parent, Incapacitated Child Over Age 21, Full Time Student 21-22 Years of Age, and Ward of a Court Form and Instruction Removed
247453 Dependency Statement - Ward of a Court Form and Instruction New
247451 Dependency Statement - Full Time Student 21-22 Years of Age Form and Instruction New
247450 Dependency Statement - Incapacitated Child Over Age 21 Form and Instruction New
247448 Dependency Statement - Parent Form and Instruction New

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 05/31/2021
16,371 14,975
14,256 14,191
315,640 305,527





table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 16,371 14,975 0 1,396 0 0
Annual Time Burden (Hours) 14,256 14,191 0 65 0 0
Annual Cost Burden (Dollars) 315,640 305,527 0 10,113 0 0


Reginfo record details
  No