Claimant Travel Reimbursement Request

Claimant Travel Reimbursement Request

OMB: 0960-0752

IC ID: 179637

Information Collection (IC) Details

View Information Collection (IC)

Claimant Travel Reimbursement Request
 
No New
 
Voluntary
 
20 CFR 404.999a-d

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-104 Claimant Travel Reimbursement Request SSA-104.doc No   Paper Only

Income Security General Retirement and Disability

 

11,092 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 11,092 0 11,092 0 0 0
Annual IC Time Burden (Hours) 1,849 0 1,849 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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