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Federal forms, ICRs, and supporting documents

Information Collection

Report of Adult Functioning-Employer

IC 221156 under ICR 202404-0960-008 · OMB 0960-0805.

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Report of Adult Functioning-Employer
 
No Modified
 
Mandatory
 
20 CFR 404.1512 20 CFR 416.912

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-3385 Report of Adult Functioning-Employer SSA-3385 (revised).pdf Yes No Fillable Printable

Income Security General Retirement and Disability

 

3,601 0
   
Private Sector Farms, Not-for-profit institutions, Businesses or other for-profits
 
   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 3,601 0 0 0 0 3,601
Annual IC Time Burden (Hours) 1,200 0 0 0 0 1,200
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Report of Adult Functioning - Employer (current) SSA-3385 (current).pdf 04/26/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.