View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 3206-0141	ICR Reference No: 198903-3206-011
Status: Historical Active	Previous ICR Reference No: 198708-3206-003
Agency/Subagency: OPM	Agency Tracking No:
Title: HEALTH BENEFITS REGISTRATION FORM (FEHBP), HEALTH BENEFITS ENROLLMENT CHANGE FORM, ENROLLMENT CODE FORM & BROCHURE REQUEST FORM, & ENROLLMENT CHANGE FORM
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR: No
Type of Review Request: Emergency	Approval Requested By: 03/07/1989
OIRA Conclusion Action: Approved with change	Conclusion Date: 03/07/1989
	Date Received in OIRA: 03/07/1989
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/1990	08/31/1990	08/31/1990
Responses	285,500	0	285,500
Time Burden (Hours)	142,750	0	35,688
Cost Burden (Dollars)	0	0	0

Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.