Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Function Report - Adult Third Party Modified 78000 79300 0 Form and Instruction SSA-3380 Function Report -- Adult Third Party
Other-Privacy Act Statement Revised
Other-PRA (revised)
Private Sector Removed 0 0 0 Form and Instruction SSA-3380 Function Report--Adult--Third Party
Total burden requested under this ICR: 78000 79300 0  
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