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Information Collection

Certification Form

IC 100539 under ICR 199408-0563-009 · OMB 0563-0033.

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Information Collection (IC) Details

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CERTIFICATION FORM
 
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 FCI-73 No No


    

1,000 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 1,000 0 0 0 0 1,000
Annual IC Time Burden (Hours) 2,000 0 0 0 0 2,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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