Information Collection

Disability Report - Child (Paper) SSA-3820-BK

IC 9538 under ICR 202602-0960-004 · OMB 0960-0577.

Documents and Forms

Document Name Document Type
Form SSA-3820-BK Disability Report - Child Disability Report - Child (Paper) SSA-3820-BK Form
SSA-3820-BK Disability Report - Child SSA-3820-BK.pdf www.ssa.gov Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Disability Report - Child (Paper) SSA-3820-BK	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:

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.pdf	www.ssa.gov	Yes	No	Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 771	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	771	-176,801	177,572
Annual IC Time Burden (Hours)	2,223	-264,135	266,358
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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

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