OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Income Verification

IC 221774 under ICR 202010-2900-006 · OMB 2900-0867.

Documents and Forms
Document Name
Document Type
Form
Other-Checklist
Form
Form
Form
Information Collection (IC) Details

View Information Collection (IC)

Income Verification
 
No Removed
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 200-1A Income Verification Response FUTURE Word Version - 200-1A - VETERAN - INCOME VERIFICATION RESPONSE-OMB Encl1.doc No   Paper Only
Form 220-1 Spouse - Income Verification Response Word Doc Future 220-1 SPOUSE 06 24 2016-OMB Encl 2.doc No   Paper Only
Form 340-1 Declaration of Representative Word Doc Future 340-1 Encl 3-.doc No   Paper Only
Other-Checklist Word Doc Future Checklist Encl 4-.doc No   Paper Only

Health Health Care Services

 

273,441 0
   
Individuals or Households
 
   0 %

  Requested 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 0 0 0 -273,441 273,441 0
Annual IC Time Burden (Hours) 0 0 0 -119,993 119,993 0
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.