Justification for Nonsubstantive or No Material Changes

Request for Non-Substantive or Non-Material Changes

Forms SSA-3375, 3376, 3377, 3378, and 3379

Function Reports - Child

20 CFR 416.924(a)

OMB No. 0960-0542

Justification for Non-Substantive Changes

Background

To assess a child claimant’s functional limitations, we collect information from individuals in a position to know the child’s daily functioning, including the child’s parent(s) or other primary caregiver(s) (hereinafter referred to just as “parent”). Forms SSA-3375-BK through SSA-3379-BK request information from the child’s parent about the child’s day-to-day functioning. The five different versions of the form contain questions about functioning appropriate to a particular age group; thus, we only use one version of the form for each child. While we do not require respondents to complete the form, it is beneficial for them to do so.

Minor Revision to the Collection Instrument

We are requesting to make revisions to the Privacy Act Statement at the recommendation of SSA’s Office of General Counsel.

This action will not affect the public reporting burden.