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
Model Employer CHIP Notice (Private Sector Burden)
Modified
174347154
900519
21619363
Other-Model Notice
Other-Model Notice Spanish
Model Employer CHIP Notice (State, Local, Tribal Governmental Burden)
Modified
2222846
11481
275637
Other-Model Notice
Other-Model Notice Spanish
Total burden requested under this ICR:
176570000
912000
21895000
To view an IC, click on IC Title