Document
Form 13441-A (Rev. 5-2018)
ICR 201906-1545-011 · OMB 1545-1842 · Object 92720701.
This document may belong to an older filing. More recent activity for OMB 1545-1842:
Document Viewer [pdf]
Status: Original and derived artifacts are available for this document.
Download: pdf
Loading document viewer…
Document Metadata
| File Type | application/octet-stream |
|---|---|
| File Title | Form 13441-A (Rev. 5-2018) |
| Subject | Health Coverage Tax Credit (HCTC) Monthly Registration and Update |
| Author | SE:W:OS:SS:OPCI |
| File Modified | 2018-05-04 |
| File Created | 2018-05-04 |
| Conversion State | complete |