Certification Regarding Adjustment For Damage Or Neglect Pursuant To 203.379(c)

CERTIFICATION REGARDING ADJUSTMENT FOR DAMAGE OR NEGLECT PURSUANT TO 203.379(C)

OMB: 2502-0349

IC ID: 144494

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CERTIFICATION REGARDING ADJUSTMENT FOR DAMAGE OR NEGLECT PURSUANT TO 203.379(C)
 
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


    

280 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 280 0 0 -340 0 620
Annual IC Time Burden (Hours) 140 0 0 -170 0 310
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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