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
SHOP - Employer
Modified
2100
336
0
Form and Instruction
CMS-10439
Appendix 1 - SHOP Application Eligibility Form
Total burden requested under this ICR:
2100
336
0
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The .gov means it's official.
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