Report Of Section 10(h)(1) Adjustment Payments In Support Of Claim For Reimbursement

REPORT OF SECTION 10(H)(1) ADJUSTMENT PAYMENTS IN SUPPORT OF CLAIM FOR REIMBURSEMENT

OMB: 1215-0065

IC ID: 122033

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REPORT OF SECTION 10(H)(1) ADJUSTMENT PAYMENTS IN SUPPORT OF CLAIM FOR REIMBURSEMENT
 
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 LS-230 No No


    

50 0
   
Private Sector Businesses or other for-profits
 
   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 -3,500 0 0 4,000
Annual IC Time Burden (Hours) 125 0 -341 0 0 466
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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