State Mental Institution Policy Review

Documents and Forms

Document Name Document Type
Revised PA & PRA Statements.pdf Other-Revised PA & PRA Statements
SSA-9584-BK State Mental Instintution Policy Review SSA-9584-BK - Revised.pdf Form
SSA-9584-BK - Current.pdf SSA-9584-BK - Current IC Document

Information Collection (IC) Details

View Information Collection (IC)

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
Other-Revised PA & PRA Statements			Revised PA & PRA Statements.pdf		Yes	No	Fillable Printable
Form	SSA-9584-BK	State Mental Instintution Policy Review	SSA-9584-BK - Revised.pdf		Yes	No	Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 68	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	68	-1	69
Annual IC Time Burden (Hours)	68	-1	69
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
SSA-9584-BK - Current	SSA-9584-BK - Current.pdf	08/24/2020

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