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Information Collection

Payment Request Form For Individuals

IC 155070 under ICR 199110-3136-001 · OMB 3136-0053.

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Information Collection (IC) Details

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PAYMENT REQUEST FORM FOR INDIVIDUALS
 
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


    

65 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 65 0 0 0 0 65
Annual IC Time Burden (Hours) 65 0 0 0 0 65
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
 
 
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.