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Waiver Study - Field Review Worksheet

IC 115336 under ICR 198302-0960-002 · OMB 0960-0332.

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WAIVER STUDY - FIELD REVIEW WORKSHEET
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-335 No No


    

3,000 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 3,000 0 3,000 0 0 0
Annual IC Time Burden (Hours) 1,500 0 1,500 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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