View Information Collection (IC)
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
View Information Collection (IC)
View RCF Information Collection (IC)
IC Title:
IDR Entity Certification and IDR Entity Monthly Reporting
Agency IC Tracking Number:
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
29 CFR 2590
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-IDR Certification Application
7. Tri-dept - IDR certification application (data elements) clean 9.28.21.docx
Yes
Yes
Fillable Printable
Other-Notice of Petition for Denial or Revocation
8. Tri-dept - notice of petition for certification denial or revocation clean 9.28.21.docx
Yes
Yes
Fillable Printable
Other-Monthly IDR Entity Reporting Requirements
9. Tri-dept - monthly IDR entity reporting requirements (data elements) clean 9.28.21.docx
Yes
Yes
Fillable Printable
Other-SDRE Determination Notice
CMS-10791- PPDR-SDRE Determination Notice.pdf
Yes
Yes
Fillable Printable
Other-SDRE Confirmation of Receipt of Settlement Information
CMS-10791 - Appendix-SDR Entity Certification Data Elements.pdf
Yes
Yes
Fillable Printable
Other-SDRE Selection Notice
CMS-10791 - PPDR-SDRE Selection Notice.pdf
Yes
Yes
Fillable Printable
Other-SDRE Entity Certification Data Elements
CMS-10791 - Appendix-SDRE Confirmation of Receipt of Settlement Notice.pdf
Yes
Yes
Fillable Printable
Other-SDRE Declining Eligibility or Need More Information
CMS-10791 - SDRE Declining Eligibility or Need More Information Notice.pdf
Yes
Yes
Fillable Printable
Other-Certified IDR Entity Written Determination
APPENDIX 6 Certified IDR Enity Written Determination.docx
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
13
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
85
0
0
0
0
85
Annual IC Time Burden (Hours)
0
0
0
0
0
0
Annual IC Cost Burden (Dollars)
22,135
0
0
0
0
22,135
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
An official website of the United States government
The .gov means it's official.
The site is secure.
