Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Appeal of Determination for Help with Medicare Prescription Drug Plan Costs - MAPS Intranet Version Unchanged 11037 1840 0 Other-Intranet Screens
Appeal of Determination for Help with Medicare Prescription Drug Plan Costs - Paper Version Modified 3283 547 0 Instruction
Form SSA-1021
Total burden requested under this ICR: 14320 2387 0  
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