Information Collection

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

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

Documents and Forms

Documents and forms in this information collection
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

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
Form	SSA-3820-BK			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 %

table that charts list of burden
	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

table that charts IC Documents
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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