This version of the form is not currently in use and is provided for reference only. Download this version of Form SSA-3377-BK for the current year.
This is a legal form that was released by the U.S. Social Security Administration on October 1, 2017 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form SSA-3377-BK?
A: Form SSA-3377-BK is a Function Report for children aged 3 to 6 years old.
Q: What is the purpose of Form SSA-3377-BK?
A: The purpose of Form SSA-3377-BK is to provide information about a child's daily activities and abilities.
Q: Who needs to complete Form SSA-3377-BK?
A: Parents or guardians of children aged 3 to 6 years old who are applying for disability benefits need to complete Form SSA-3377-BK.
Q: What information is required in Form SSA-3377-BK?
A: Form SSA-3377-BK asks for information about the child's daily activities, such as self-care, mobility, communication, and learning.
Q: Is Form SSA-3377-BK specific to the United States?
A: Yes, Form SSA-3377-BK is specific to the United States and is used by the Social Security Administration (SSA) for disability benefit applications.
Q: How long does it take to complete Form SSA-3377-BK?
A: The time to complete Form SSA-3377-BK varies depending on the individual, but it typically takes around 30 minutes to an hour.
Q: What should I do if I need help completing Form SSA-3377-BK?
A: If you need help completing Form SSA-3377-BK, you can contact the Social Security Administration (SSA) or seek assistance from a disability advocate or attorney.
Form Details:
Download a fillable version of Form SSA-3377-BK by clicking the link below or browse more documents and templates provided by the U.S. Social Security Administration.