Certified Eligibility for Adjustments for Damage or Neglect

Certified Eligibility for Adjustments for Damage or Neglect

OMB: 2502-0349

IC ID: 27140

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Certified Eligibility for Adjustments for Damage or Neglect
 
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


    

250 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 250 0 0 -30 0 280
Annual IC Time Burden (Hours) 125 0 0 -15 0 140
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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