PRA Statement

PRA statement.doc

Request for Evidence from Doctor or Hospital

PRA Statement

OMB: 0960-0722

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Revised Paperwork Reduction Act Statement – OHA Forms



Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget control number. We estimate that it will take about 15 minutes to read the instructions, gather the facts, and answer the questions. You may send comments on our time estimate above to: SSA, 6401 Security Blvd, Baltimore, MD 21235-6401. Send only comments relating to our time estimate to this address, not the completed form.


File Typeapplication/msword
File TitlePaperwork Reduction Act Statement - This information collection meets the clearance requirements of 44 U
Author341920
Last Modified ByKathy
File Modified2008-01-23
File Created2008-01-23

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