PRA IC List
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Agenda
Reg Review
ICR
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)
Modified
37200
24800
0
Other-Internet Application
Certificate of Coverage Request via Internet - Employers in Denmark, Netherlands, Norway, & Sweden
Unchanged
1680
1232
0
Other-Internet Application
Certificate of Coverage Request via Internet - Individuals (minus Denmark, Netherlands, Norway, & Sweden)
Modified
9299
6199
0
Other-Internet Application
Other-Revised PA
Certificate of Coverage Request via Internet - Individuals in Denmark, Netherlands, Norway, & Sweden
Unchanged
421
309
0
Other-Internet Application
Certificate of Coverage Request via Letter - Employers (minus Denmark, Netherlands, Norway, & Sweden)
Modified
24799
16533
0
Instruction
Certificate of Coverage Request via Letter - Employers in Denmark, Netherlands, Norway, & Sweden
Unchanged
1121
822
0
Instruction
Certificate of Coverage Request via Letter - Individuals (minus Denmark, Netherlands, Norway, & Sweden)
Modified
6200
4133
0
Instruction
Certificate of Coverage Request via Letter - Individuals in Denmark, Netherlands, Norway, & Sweden
Unchanged
280
205
0
Instruction
Total burden requested under this ICR:
81000
54233
0
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