Ssa-714 (07-05)

Form SSA-714 (07-05).pdf

Repayment of Debt

SSA-714 (07-05)

OMB: 3220-0169

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 3220-0169 can be found here:

2023-03-28 - Extension without change of a currently approved collection

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File Modified	2016-04-25
File Created	2016-04-25

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