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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Change of Ownership (Private)
Modified
42
42
0
Change of Ownership (Public)
Modified
33
33
0
Data Inaccuracies (Private)
Modified
2063
181544
0
Data Inaccuracies (Public)
Modified
1688
148544
0
Early Retiree Reinsurance Program - Private Application
Modified
4125
90750
0
Early Retiree Reinsurance Program - Public Application
Modified
3375
74250
0
Fraud and Abuse Procedures (Private) - Out Years
Modified
1032
20640
0
Fraud and Abuse Procedures (Private) - Year 1
Modified
2064
41280
0
Fraud and Abuse Procedures (Public) - Out Years
Modified
844
16880
0
Fraud and Abuse Procedures (Public) - Year 1
Modified
1688
33760
0
Mainenance of Records (Private)
Modified
4125
24750
0
Maintenance of Records (Public)
Modified
3375
20250
0
Reimbursement Requests (Private)
Modified
8250
726000
0
Reimbursement Requests (Public)
Modified
6750
594000
0
Written Agreements (Private ) - Year 1
Modified
16500
16500
0
Written Agreements (Private) - Out Years
Modified
1032
1032
0
Written Agreements (Public) - Out Years
Modified
844
844
0
Written Agreements (Public) - Year 1
Modified
13500
13500
0
Total burden requested under this ICR:
71330
2004599
0
To view an IC, click on IC Title