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Federal forms, ICRs, and supporting documents

Information Collection

Disability Report - Child (Paper) SSA-3820

IC 9538 under ICR 202411-0960-003 · OMB 0960-0577.

Documents and Forms
Document Name
Document Type
Form
Other-Revised Privacy Act Statement
Other-Revised Privacy Act Statement
Other-Certification Statement Form
Other-Certification Statement Form
Form
Form
IC Document
IC Document
Information Collection (IC) Details

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Disability Report - Child (Paper) SSA-3820
 
No Modified
 
Voluntary
 
20 CFR 416.912

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-3820-BK Disability Report - Child SSA-3820-BK (revised).pdf Yes No Fillable Printable
Other-Revised Privacy Act Statement 0577 0960-0577 Privacy Act Statement (revised).doc No   Paper Only
Other-Certification Statement Form Mock-Up Certification Statement Form - FINAL.pdf No   Paper Only

Income Security General Retirement and Disability

 

177,572 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 177,572 0 0 0 0 177,572
Annual IC Time Burden (Hours) 266,358 0 0 0 0 266,358
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-3820-BK Disability Report -Child Current Version SSA-3820-BK (current).pdf 02/08/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.