Information Collection

Request for Waiver of Service Obligation; Request for Deferment of Service Obligation; Application for Review

IC 26650 under ICR 200203-2133-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type

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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; Application for Review	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-937	No	No
Form	MA-936	No	No
Form	MA-935	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 61	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	61	-14	75
Annual IC Time Burden (Hours)	21	-4	25
Annual IC Cost Burden (Dollars)	0	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.