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Application for Employer Reporting Internet Access
BA-12 (07-17).pdf
RUIA Claims Notification and Verification System
Application for Employer Reporting Internet Access
OMB: 3220-0171
OMB.report
RRB
OMB 3220-0171
ICR 201712-3220-002
Application for Employer Reporting Internet Access
( Supplementary Document )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 3220-0171 can be found here:
2021-03-31 - Revision of a currently approved collection
Document [pdf]
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File Title
KM_284e-20171222112158
File Modified
2017-12-22
File Created
2017-12-22
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