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Form 710 Uncompensated Services Assurance Report
Uncompensated Services Assurance Report
HRSAForm710
Uncompensated Services Assurance Report
OMB: 0915-0077
OMB.report
HHS/HSA
OMB 0915-0077
ICR 200904-0915-001
IC 6349
Form 710 Uncompensated Services Assurance Report
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0915-0077 can be found here:
2012-06-25 - Extension without change of a currently approved collection
2012-05-02 - Revision of a currently approved collection
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File Modified
0000-00-00
File Created
2009-04-09
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