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SSA-3380-BK Function Report--Adult--Third Party (Revised Version)
Function Report - Adult Third Party, 20 CFR 404.1512 and 416.912
3380
Function Report - Adult Third Party, 20 CFR 404.1512 and 416.912
OMB: 0960-0635
OMB.report
SSA
OMB 0960-0635
ICR 200608-0960-004
IC 9663
SSA-3380-BK Function Report--Adult--Third Party (Revised Version)
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0960-0635 can be found here:
2021-11-01 - Revision of a currently approved collection
2018-08-20 - Revision of a currently approved collection
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File Type
application/pdf
Subject
ssa3380
Author
TOSICK, BILL
File Modified
0000-00-00
File Created
2006-08-17
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