ID-4K (Internet) Prepayment Notice of Employees' Applications and Claims

RUIA Claims Notification and Verification System

Form ID-4K (Internet) (02-09)

RUIA Claims Notification System

OMB: 3220-0171

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 3220-0171 can be found here:

2025-06-13 - Reinstatement with change of a previously approved collection
2021-03-31 - Revision of a currently approved collection

Document [pdf]

Download: pdf | pdf

Current
ID-4K (02-09)

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File Type	application/pdf
Author	Dana Hickman
File Modified	2014-12-02
File Created	2014-12-02