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Client Eligibility Documentation Form

IC 254744 under ICR 202409-2528-002 · OMB 2528-0335.

Documents and Forms
Document Name
Document Type
Other-Client Eligibility Documentati
Other-Client Eligibility Documentati
Other-Appendix B. Client Eligibility
Other-Appendix B. Client Eligibility
Information Collection (IC) Details

View Information Collection (IC)

Client Eligibility Documentation Form
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Client Eligibility Documentation Form Appendix B. Client Eligibility Documentation Form_OAHM_Final.docx No   Paper Only
Other-Appendix B. Client Eligibility _EOAHMP-C2.DRAFT (clean) Appendix B. Client Eligibility _EOAHMP-C2.DRAFT (clean).docx No   Paper Only

Community and Social Services Community and Regional Development

 

4,478 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 4,478 0 0 0 0 4,478
Annual IC Time Burden (Hours) 358 0 0 0 0 358
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.