OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Annex D: Application for Modification of a Decision, including Restricted Information on the Applicant

IC 224048 under ICR 202212-0970-004 · OMB 0970-0488.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Annex D: Application for Modification of a Decision, including Restricted Information on the Applicant
 
No Unchanged
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Application for Modification of a Decision Annex D_Application_for_Modification_of_a_Decision OMB.docx Yes Yes Fillable Printable

Community and Social Services Social Services

 

54 0
   
State, Local, and Tribal Governments
 
   50 %

  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 216 0 0 0 0 216
Annual IC Time Burden (Hours) 108 0 0 0 0 108
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.