Information Collection

Application for Disability Insurance Benefits - 20 CFR, Subpart P, 404.1501-.1512 and Subpart D, 404.315-.322

IC 37942 under ICR 200312-0960-010 · OMB 0960-0060.

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IC Title:

Application for Disability Insurance Benefits - 20 CFR, Subpart P, 404.1501-.1512 and Subpart D, 404.315-.322

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-16-F6				Yes	Yes

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,513,677

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 97 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	1,513,677	1,513,677
Annual IC Time Burden (Hours)	504,559	504,559
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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Title	Document	Date Uploaded

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

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