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Statement Of Contingent Or Other Fees (representation And Agreement)

IC 153237 under ICR 198306-3090-002 · OMB 3090-0017.

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STATEMENT OF CONTINGENT OR OTHER FEES (REPRESENTATION AND AGREEMENT)
 
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 SF 119 No No


    

2,600 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 52,100 0 0 52,000 0 100
Annual IC Time Burden (Hours) 214 0 0 114 0 100
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.