Information Collection Request
Report of Adult Functioning-Employer
ICR 202402-0960-007 · OMB 0960-0805 · Active
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0960-0805 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form SSA-3385 Report of Adult Functioning-Employer |
Form | Modified | Available |
 Justification for a Non-Substantive Change 0960-0805.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2024-02-22 | Available |
| Supporting Statement - 0805 (Clean Copy).docx |
Supporting Statement A | Uploaded 2023-08-24 | Available |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 221156 |  Report of Adult Functioning-Employer |
Form | Modified |
ICR Details
| Status | Active |
|---|---|
| Agency/Subagency | SSA |
| OMB Control No | 0960-0805 |
| Type of Information Collection | No material or nonsubstantive change to a currently approved collection |
| Previous ICR Reference No | 202207-0960-008 |
| Date Submitted to OIRA | 2024-02-22 |
| Requested Expiration Date | 1969-12-31 |