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Eligibility Questionnaire For HAVANA Act Payments
Eligibility Questionnaire for HAVANA Act Payments
OMB: 1405-0250
IC ID: 253057
OMB.report
STATE/AFA
OMB 1405-0250
ICR 202601-1405-001
IC 253057
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0250 can be found here:
2026-01-15 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form DS-4316
Eligibility Questionnaire For HAVANA Act Payments
Form and Instruction
Information Collection (IC) Details
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