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Statement Of Physical Ability For Light Duty Work

IC 176558 under ICR 199405-3206-004 · OMB 3206-0013.

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STATEMENT OF PHYSICAL ABILITY FOR LIGHT DUTY WORK
 
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 SF-177 No No


    

678 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 678 0 0 0 0 678
Annual IC Time Burden (Hours) 113 0 0 0 0 113
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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