Information Collection

Psychiatric Review Technique - 20 CFR 404.1520(a), 20 CFR 416.920(a)

IC 9264 under ICR 200608-0960-002 · OMB 0960-0413.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-2506-BK Psychiatric Review Technique - 20 CFR 404.1520(a), 20 CFR 416.920(a)	Form
SSA-2506-BK Psychiatric Review Technique PRTF_for.pdf co.ba.ssa.gov/eForms/forms/formselector.htm	Form

IC Title:

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 404.1520a 20 CFR 416.920a

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-2506-BK	Psychiatric Review Technique	PRTF_for.pdf	http://co.ba.ssa.gov/eForms/forms/formselector.htm	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 52

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 80 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,070,940	-182,763	1,253,703
Annual IC Time Burden (Hours)	267,735	-45,691	313,426
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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