DAAS-3004 Referral to SSA for Waiver or Reduction of Overpayment Recoupment

Form NumberDAAS-3004
Agency/DivisionAging and Adult Services (DAAS)
Form Effective Date 2011-12-01T12:40:00-05:00
Form File DAAS-3004.pdf


Form Content

DAAS-3004 Referral to SSA for Waiver or Reduction of Overpayment Recoupment