PRA IC List
Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
APPLICATION FOR EMPLOYEES AND SPOUSES ELIGIBILITY TO HOSPITAL INSURANCE BENEFITS
Migrated
6000
1000
0
Form
AA-101
Form
AA-103
Total burden requested under this ICR:
6000
1000
0
To view an IC, click on IC Title
An official website of the United States government
The .gov means it's official.
The site is secure.
