Request For Waiver Of Service Obligation, Request For Deferment Of Service Obligation, Request For Review Of Waiver/deferment Decisions

REQUEST FOR WAIVER OF SERVICE OBLIGATION, REQUEST FOR DEFERMENT OF SERVICE OBLIGATION, REQUEST FOR REVIEW OF WAIVER/DEFERMENT DECISIONS

OMB: 2133-0510

IC ID: 142895

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REQUEST FOR WAIVER OF SERVICE OBLIGATION, REQUEST FOR DEFERMENT OF SERVICE OBLIGATION, REQUEST FOR REVIEW OF WAIVER/DEFERMENT DECISIONS
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form MA-935 No No
Form MA-936 No No
Form MA-937 No No


    

100 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 100 0 0 100 0 0
Annual IC Time Burden (Hours) 30 0 0 30 0 0
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.

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