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Information Collection

Eligibility Data Form

IC 168316 under ICR 198107-1210-003 · OMB 1210-0010.

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ELIGIBILITY DATA FORM
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form LMSA 1010 No No


    

3,500 0
   
Individuals or Households
 
   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) 875 0 0 0 0 875
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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