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Federal forms, ICRs, and supporting documents

Information Collection

Request for and Consent to Release of Information from Claimant's Records

IC 42177 under ICR 200210-2900-010 · OMB 2900-0025.

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Information Collection (IC) Details

View Information Collection (IC)

Request for and Consent to Release of Information from Claimant's Records
 
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 3288 No No


    

151,000 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 151,000 0 0 0 0 151,000
Annual IC Time Burden (Hours) 18,875 0 0 0 0 18,875
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.