Document
Verification Form
ICR 201812-0915-001 · OMB 0915-0140 · Object 88311501.
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 queued and waiting for the next worker pass. (priority 70 · next 2026-05-14 02:05:56)
Missing: html
Download: Source copy (docx)
Loading document viewer…
Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | Verification Form |
| Author | Ali, Israil (HRSA) |
| File Created | 2021-01-16 |
| Conversion State | partial |