OMB.report

Federal forms, ICRs, and supporting documents

Document

Screenshots for Web version

ICR 202412-1121-001 · OMB 1121-0312 · Object 150123801.

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Document Metadata

Record metadata
File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleScreenshots for Web version
AuthorBecki Goggins
Last Modified ByWriter
File Modified2024-11-25
File Created2026-08-25
Conversion Statecomplete

Extracted Text

Attachment 4 – Screenshots for 2022 web form (2024 not yet developed)