Document

Request for Dispute Resolution

ICR 202610-0906-006 · OMB 0906-0081 · Object 174168500.

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Document Metadata

Record metadata
application/pdf
Request for Dispute Resolution
Adobe Acrobat (64-bit) 26.1.21431
2026-06-24
2026-04-28
complete

Extracted Text

Request for Dispute Resolution Form and Instruction

State Changes
Label
OMB Number:
0906-0081
Expiration
Date:
mm/dd/yyyy

PDF Name

Item Type

Request for
Modal
Dispute Resolution

Trigger
When the user selects the link the modal is displayed
with the public burden statement content.