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: 199008-3206-007
Status: Historical Active	Previous ICR Reference No: 198903-3206-011
Agency/Subagency: OPM	Agency Tracking No:
Title: OPM 2809: HEALTH BENEFITS REGISTRATION FORM OPM 2809, EZ-1, 2: HEALTH BENEFITS ENROLLMENT CHANGE FORM
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/05/1990
	Date Received in OIRA: 08/14/1990
Terms of Clearance: This limited approval is given in light of OPM's commitment to restructure the current FEHBP. It is anticipated that any changed FEHBP will require substantially changed forms requiring OMB approval under the Paperwork Reduction Act. OPM may modify dates in form instruction to make appropriate references to each open season year.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/1992	06/30/1992	08/31/1990
Responses	285,500	0	285,500
Time Burden (Hours)	142,750	0	142,750
Cost Burden (Dollars)	0	0	0

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