Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Notice of Availability of Separate Payments for Contraceptive Services New 210245 68 52565 Other-Model
Notice of Revocation of Accommodation New 64379 109 16096
Self-Certification or Notiffication Modified 5 4 1 Other-Model Notice
Form EBSA Form 700 Eligible Organization Self-Certification
Total burden requested under this ICR: 274629 181 68662  
To view an IC, click on IC Title