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Information Collection

Application For Award Of Exemplary Rehabilitation Certificate

IC 120847 under ICR 198010-1205-004 · OMB 1205-0124.

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Information Collection (IC) Details

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APPLICATION FOR AWARD OF EXEMPLARY REHABILITATION CERTIFICATE
 
No Migrated
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form ETA 753 No No
Form ETA 752 No No


    

250 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 250 0 250 0 0 0
Annual IC Time Burden (Hours) 188 0 188 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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