Information Collection Request

Request for Waiver of Service Obligation, Request for Deferment of Service Obligation, Application for Review

ICR 201411-2133-001 · OMB 2133-0510 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form MA-935 Request for Waiver of Service Obligation, request for Deferment of Service Obligation, Application for Review Form and Instruction Modified Available
30-Day FRN.pdf Supplementary Document Uploaded 2014-11-13 Available
60-Day FRN.pdf Supplementary Document Uploaded 2014-11-12 Available
Supporting Statement_2014.docx Supporting Statement A Uploaded 2014-11-25 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
26651 Request for Waiver of Service Obligation, request for Deferment of Service Obligation, Application for Review Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
01/31/2018 36 Months From Approved 01/31/2015
11 0 11
3 0 3
7 0 7





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 11 11 0 0 0 0
Annual Time Burden (Hours) 3 3 0 0 0 0
Annual Cost Burden (Dollars) 7 7 0 0 0 0


Reginfo record details
  No