View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Internet Claim (iClaim) and SSA-3368 Adult Disability Report End of Task Survey	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Internet Claim (iClaim) and SSA-3368 Adult Disability Report End of Task Survey			Internet Claim (iClaim) and SSA-3368 Adult Disability Report End of Task Survey.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	100,000	0	100,000	0	0	0
Annual IC Time Burden (Hours)	8,333	0	8,333	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Description of iClaim Survey	Description of Internet Claim (iClaim) OMB REV 2 25 25.pdf	02/25/2025

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