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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Request for Employment Information in Connection with Claim for Disability Benefits
Modified
60000
15000
0
Form
21-4192
Request for Employment Information in Connection with Claim for Disability Benefits
Total burden requested under this ICR:
60000
15000
0
To view an IC, click on IC Title
An official website of the United States government
The .gov means it's official.
The site is secure.
