Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Certificate of Coverage Request via Internet - Employers (Poland) Modified 243 166 0 Instruction
Other- Totalization Agreements Unified Webpage Screen Shot
Certificate of Coverage Request via Internet - Employers (minus Denmark, Netherlands, Norway, & Sweden and Urugay) Modified 25165 16777 0 Other-Internet Application
Other- Totalization Agreements Unified Webpage Screen Shot
Certificate of Coverage Request via Internet - Employers in Denmark, Iceland, Netherlands, Norway, Slovenia, Sweden & Uruguay) Modified 1937 1420 0 Other-Internet Application
Other- Totalization Agreements Unified Webpage Screen Shot
Certificate of Coverage Request via Internet - Individuals (Poland) Modified 52 36 0 Other-Internet Screens
Other- Totalization Agreements Unified Webpage Screen Shot
Certificate of Coverage Request via Internet - Individuals (minus Denmark, Netherlands, Norway, & Sweden) Modified 3253 2169 0 Other-Internet Application
Other- Totalization Agreements Unified Webpage Screen Shot
Certificate of Coverage Request via Internet - Individuals in Denmark, Iceland, Netherlands, Norway, Slovenia, Sweden & Uruguay Modified 122 89 0 Other-Internet Application
Other- Totalization Agreements Unified Webpage Screen Shot
Certificate of Coverage Request via Letter - Employers (Poland) Unchanged 18 12 0 Instruction
Other-Revised PA Statement
Certificate of Coverage Request via Letter - Employers (minus Denmark,Iceland, Netherlands, Norway, Poland, Solvenia, Sweden & Uruguay) Unchanged 1135 757 0 Instruction
Other-Revised PA Statement
Certificate of Coverage Request via Letter - Employers in Denmark, Iceland, Netherlands, Norway, Slovenia, Sweden & Uruguay) Unchanged 168 123 0 Instruction
Other-Revised PA Statement
Certificate of Coverage Request via Letter - Individuals (Poland) Unchanged 31 21 0 Instruction
Other-Revised PA Statement
Certificate of Coverage Request via Letter - Individuals (minus Denmark, Iceland, Netherlands, Norway, Slovenia, Sweden & Uruguay) Unchanged 511 341 0 Instruction
Other-Revised PA Statement
Certificate of Coverage Request via Letter - Individuals in Denmark, Netherlands, Norway, & Sweden, and Uruguay Modified 87 64 0 Instruction
Other-Revised PA Statement
Instruction
Total burden requested under this ICR: 32722 21975 0  
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