Document
Authorization to Release Information Form
ICR 201804-0915-004 · OMB 0915-0140 · Object 82523601.
This document may belong to an older filing. More recent activity for OMB 0915-0140:
Document Viewer [docx]
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 2026-04-23 04:43:09)
Missing: html
Download: Source copy (docx)
Loading document viewer…
Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | Authorization to Release Information Form |
| Author | HRSA |
| File Created | 2021-01-21 |
| Conversion State | partial |