Questionnaire for Children Claiming SSI Benefits

Documents and Forms

Document Name Document Type
Revised PRA Statement.pdf Other-Revised PRA Statement
SSA-3881 BK Questionnaire for Children Claiming SSI Benefits SSA-3881-BK - Revised.pdf Form
SSA-3881-BK - Current.pdf Questionnaire for Children Claiming SSI Benefits - Current IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Questionnaire for Children Claiming SSI Benefits	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 416.912(a)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Revised PRA Statement			Revised PRA Statement.pdf		Yes	No	Fillable Printable
Form	SSA-3881 BK	Questionnaire for Children Claiming SSI Benefits	SSA-3881-BK - Revised.pdf		Yes	No	Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 125,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	125,000	-5,000	130,000
Annual IC Time Burden (Hours)	62,500	-2,500	65,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Questionnaire for Children Claiming SSI Benefits - Current	SSA-3881-BK - Current.pdf	09/08/2020

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