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Statement of Claimant or Other Person-Medical Resident FICA Refund Claims
OMB 0960-0786
OMB.report
SSA
OMB 0960-0786
OMB 0960-0786
Latest Forms, Documents, and Supporting Material
Document
Name
Form SSA-795-OP2 Statement of Claimant or Other Person-Medical Resident FICA Refund Claims
Form
Addendum to Supporting Statement SSA-795-OP2.docx
Supporting Statement B
Supporting Statement 0786 (revised).docx
Supporting Statement A
Statement of Claimant or Other Person-Medical Resident FICA Refund Claims
Form
All Historical Document Collections
201107-0960-002
Approved without change
Revision of a currently approved collection
2011-10-12
201102-0960-006
Approved without change
New collection (Request for a new OMB Control Number)
2011-04-06
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