OMB control number

Statement For Recipients Of Medical And Health Care Payments

OMB 1545-0114 · TREAS/IRS.

OMB 1545-0114

Latest Forms, Documents, and Supporting Material

Document Name
STATEMENT FOR RECIPIENTS OF MEDICAL AND HEALTH CARE PAYMENTS Form

All Historical Document Collections

198108-1545-048 Approved without change	Revision of a currently approved collection	1981-08-12
198104-1545-114 Approved without change	Revision of a currently approved collection	1981-04-01