PRA IC List
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Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Certificate of Coverage Request via Internet - Employers (minus Denmark, Netherlands, Norway, & Sweden) New 31920 21280 0 Other-Internet Application
Certificate of Coverage Request via Internet - Employers in Denmark, Netherlands, Norway, & Sweden New 1680 1232 0 Other-Internet Application
Certificate of Coverage Request via Internet - Individuals (minus Denmark, Netherlands, Norway, & Sweden) Modified 7979 5319 0 Other-Internet Application
Other-Revised PA
Certificate of Coverage Request via Internet - Individuals in Denmark, Netherlands, Norway, & Sweden New 421 309 0 Other-Internet Application
Certificate of Coverage Request via Letter - Employers (minus Denmark, Netherlands, Norway, & Sweden) New 21279 14186 0 Instruction
Certificate of Coverage Request via Letter - Employers in Denmark, Netherlands, Norway, & Sweden New 1121 822 0 Instruction
Certificate of Coverage Request via Letter - Individuals (minus Denmark, Netherlands, Norway, & Sweden) Modified 5320 3547 0 Instruction
Certificate of Coverage Request via Letter - Individuals in Denmark, Netherlands, Norway, & Sweden New 280 205 0 Instruction
Total burden requested under this ICR: 70000 46900 0  
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