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Information Collection

Member Incapacitated Due To Injury Or Illness

IC 164976 under ICR 198906-0701-005 · OMB 0701-0076.

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Information Collection (IC) Details

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MEMBER INCAPACITATED DUE TO INJURY OR ILLNESS
 
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 AFAFC 2192 No No


    

122 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 122 0 0 0 0 122
Annual IC Time Burden (Hours) 61 0 0 0 0 61
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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