State Mental Institution Policy Review

State Mental Institution Policy Review, 404.2035, .2065, 416.635, .665

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0110 can be found here:

Documents and Forms

Document Name Document Type
Form SSA-9584-BK State Mental Institution Policy Review Form
SSA-9584-BK State Mental Instintution Policy Review SSA-9584-BK.pdf Form

Information Collection (IC) Details

IC Title:	State Mental Institution Policy Review	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 404.2035 20 CFR 404.2065 20 CFR 416.635 20 CFR 416.665

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-9584-BK	State Mental Instintution Policy Review	SSA-9584-BK.pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 95	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	95	-5	100
Annual IC Time Burden (Hours)	95	-5	100
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.