Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Third Party Liability Information Statement Modified 200 17 0 Form SSA-8019-U2 Third Party Liability Information Statement
Other-Privacy Act Statement (revised) 0323
Third Party Liability Information Statement Modified 49621 4135 0 Other-Internal Screens
Total burden requested under this ICR: 49821 4152 0  
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