Financial Statement Of Debtor

FINANCIAL STATEMENT OF DEBTOR

OMB: 0938-0270

IC ID: 113305

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FINANCIAL STATEMENT OF DEBTOR
 
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 HCFA-379 No No


    

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 500 0 500 0 0 0
Annual IC Time Burden (Hours) 1,000 0 1,000 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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