Renewal Certification

Medical Permit Parking Application

OMB: 0960-0624

IC ID: 186166

Documents and Forms
Information Collection (IC) Details

View Information Collection (IC)

Renewal Certification
 
No Unchanged
 
Required to Obtain or Retain Benefits
 
41 CFR 110.20-104.2

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction SSA-3194 Renewal Certification Final Renewal Certification.doc No   Paper Only

General Government Central Personnel

 

500 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 500 0 0 0 0 500
Annual IC Time Burden (Hours) 42 0 0 0 0 42
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-3194 Renewal Certification SSA-3194.pdf 07/11/2011
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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