Eligibility Questionnaire for HAVANA Act Payments

ICR 202211-1405-004

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1405-0250 can be found here:

Forms and Documents

Document Name	Status
Form DS-4316 Eligibility Questionnaire For HAVANA Act Payments Form and Instruction	Modified
ds4316 Aug 2022.pdf Supplementary Document	2022-11-21
Legal Authorities -30-day HAVANA Act PRA.docx Supplementary Document	2022-11-21
30-day Supporting Statement -- HAVANA Act 1405-0250.docx Supporting Statement A	2022-11-21

IC Document Collections

IC ID	Document Title	Status
253057	Eligibility Questionnaire For HAVANA Act Payments Form and Instruction	Modified

ICR Details