Statement Of Institution Or Social Agency

STATEMENT OF INSTITUTION OR SOCIAL AGENCY

OMB: 0960-0083

IC ID: 166529

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STATEMENT OF INSTITUTION OR SOCIAL AGENCY
 
No Migrated
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-1255 No No


    

3,500 0
   
State, Local, and Tribal Governments
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 3,500 0 0 0 0 3,500
Annual IC Time Burden (Hours) 600 0 0 0 0 600
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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