Document
Form Approved
ICR 201705-0955-001 · OMB 0955-0009 · Object 73954501.
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Status: The document is viewable, but some background extraction is still pending.
Queue: Repair is in progress, but the document is still incomplete and remains in the worker queue. (priority 70 · next 2026-09-26 10:39:43)
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Document Metadata
| File Type | application/msword |
|---|---|
| File Title | Form Approved |
| Author | DHHS |
| Last Modified By | Windows User |
| File Modified | 2016-04-22 |
| File Created | 2016-04-22 |
| Conversion State | partial |