Information Collection

Disability Report - Child (Internet)

IC 179519 under ICR 202602-0960-004 · OMB 0960-0577.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
i3820 - Internet Screens.pdf www.ssa.gov	Other-Disability Report - Child (Int
i3820 screens (current).pdf Disability Report-Child (Internet)	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 416.912

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Disability Report - Child (Internet)				www.ssa.gov	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: 96,481

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	96,481	-80,091	176,572
Annual IC Time Burden (Hours)	289,443	-63,701	353,144
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Disability Report-Child (Internet)		02/12/2024

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

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