Function Report, Child (Birth to 1st, Age 1 to 3rd, Age 3 to 6th, Age 6 to 12th, Age 12 to 18th Birthday)

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Documents and Forms

Document Name Document Type

no available documents/forms check other ICs listed under this ICR

Information Collection (IC) Details

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IC Title:	Function Report, Child (Birth to 1st, Age 1 to 3rd, Age 3 to 6th, Age 6 to 12th, Age 12 to 18th Birthday)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	3377	No	No
Form	3376	No	No
Form	3379	No	No
Form	SSA-3375	No	No
Form	3378	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	500,000	500,000
Annual IC Time Burden (Hours)	166,667	166,667
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded

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