Information Collection

Request For Waiver Of Service Obligation, Request For Deferment Of Service Obligation, Request For Review Of Waiver/deferment Decisions

IC 142895 under ICR 198412-2133-001 · OMB 2133-0510.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2133-0510 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	REQUEST FOR WAIVER OF SERVICE OBLIGATION, REQUEST FOR DEFERMENT OF SERVICE OBLIGATION, REQUEST FOR REVIEW OF WAIVER/DEFERMENT DECISIONS	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	MA-935	No	No
Form	MA-936	No	No
Form	MA-937	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	30	30
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded

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