Forms.gov - The U.S. Government's Official Hub for Federal Forms

Forms Search:
Function Report - Adult Third Party
Function Report - Adult Third Party - Form SSA-3380 is used to obtain the types of information specified in the regulations and to provide disability interviewers (and third parties in self-help situations) with a convenient means to record information about how the claimant's condition affects his or her ability to function. The State Disability Determination Service (DDS) evaluator uses the information to assess the alleged disability. The information, together with medical evidence, forms the evidentiary basis upon which the initial disability evaluation process is founded.
Form #:  SSA 3380 BK
Agency:  Social Security Administration
  TYPE PAGES SIZE (KB) CAPABILITY WHAT'S
NEEDED
paper Both Form and Instructions 11   [1] Paper Only Other Client Software  

Still Cannot Find a Specific Form Here?

 If you do not find the form you need in the E-Forms Catalog we suggest:

Search through the Agency Forms links.

Search USA.gov, a connection to the U.S. Government's information and services.

Search GSA (GS), Standard (SF) and Optional (OF) Forms, the General Services Administration's library for GSA internal forms and government-wide Standard and Optional Forms.