Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Function Report - Child (SSA-3375, SSA-3376, SSA-3377, SSA-3378, SSA-3379) - Paper Forms Removed 0 0 0 Form SSA-3375
Form SSA-3376-BK
Form SSA-3377-BK
Form SSA-3378-BK
Form SSA-3379-BK
Other-Revised Privacy Act Statement
Function Report - Child (SSA-3375, SSA-3376, SSA-3377, SSA-3378, SSA-3379) - Phone Interview Removed 0 0 0 Form SSA-3375-BK
Form SSA-3376-BK
Form SSA-3377-BK
Form SSA-3378-BK
Form SSA-3379-BK
Other-Revised Privacy Act Statement for Forms SSA-3375 - SSA-3379
Function Report Child - Child Age 1 to 3rd Birthday - SSA-3376 New 53347 80910 0 Form and Instruction SSA-3376-BK
Function Report Child - Child Age 12 to 18th Birthday - SSA-3379 New 142006 215376 0 Form and Instruction SSA-3379-BK
Function Report Child - Child Age 3 to 6th Birthday - SSA-3377 New 108745 164930 0 Form and Instruction SSA-3377-BK
Function Report Child - Child Age 6 to 12th Birthday - SSA-3378 New 193800 293930 0 Form and Instruction SSA-3378-BK
Function Report Child - Child Birth to 1st Birthday - SSA-3375 New 26864 40744 0 Form and Instruction SSA-3375-BK
Total burden requested under this ICR: 524762 795890 0  
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