Claim Documentation Form Hardship to Dependents

Documents and Forms

Document Name Document Type
Form SSS FORM 24 Claim Documentation Form Hardship to Dependents Form and Instruction
SSS FORM 24 Claim Documentation Form - Hardship to Dependents SSS FORM 24.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Claim Documentation Form Hardship to Dependents	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSS FORM 24	Claim Documentation Form - Hardship to Dependents	SSS FORM 24.pdf		No		Paper Only

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	1	1
Annual IC Time Burden (Hours)	1	1
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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