Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Employer Coverage Under an Employer Group Health Plan Modified 2000 333 0 Form and Instruction RL-311-F (03-10)
Medicare Modified 240 32 0 Form and Instruction AA-6 (01-12)
Form and Instruction AA-7 (01-12)
Form and Instruction AA-8 (01-12)
Total burden requested under this ICR: 2240 365 0  
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