DS-4316 Eligibility Questionnaire for HAVANA Act payments

ELIGIBILITY QUESTIONNAIRE FOR HAVANA ACT PAYMENTS-FBI

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1405-0250 can be found here:

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File Type	application/pdf
File Title	DS-4316
Subject	Eligibility Questionnaire for Havana Act Payments
File Modified	2026-01-05
File Created	2023-01-24