Information Collection

Student Reporting Form

IC 9034 under ICR 202502-0960-004 · OMB 0960-0088.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-1383 Student Reporting Form	Form and Instruction
Form SSA-1383 Student Reporting Form Student Reporting Form	Form and Instruction
Revised PA & PRA Statements for SSA-1383 and SSA-1383-FC (0960-0088).pdf	Other-Revised Privacy Act and PRA St
Revised PA & PRA Statements for SSA-1383 and SSA-1383-FC (0960-0088).pdf	Other-Revised Privacy Act and PRA St
SSA-1372 - POS-MACADE screens.pdf	Other-Internal Screens
SSA-1372 - POS-MACADE screens.pdf	Other-Internal Screens
SSA-1383 Student Reporting Form SSA-1383 - Revised Version.pdf	Form and Instruction
SSA-1383 Student Reporting Form SSA-1383 - Revised Version.pdf	Form and Instruction
SSA-1383 - Current Version.pdf Current SSA-1383	IC Document
SSA-1383 - Current Version.pdf Current SSA-1383	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 422.135 20 CFR 404.415 20 CFR 404.367 20 CFR 404.352(b)(2) 20 CFR 404.368 20 CFR 404.434

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSA-1383	Yes	No	Fillable Printable
Other-Revised Privacy Act and PRA Statements		No		Paper Only
Other-Internal Screens		Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 8,158

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	8,158	-66,842	75,000
Annual IC Time Burden (Hours)	18,763	11,263	7,500
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Current SSA-1383		06/25/2025

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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