Information Collection Request

APPLICATION FOR REINSTATEMENT (NONMEDICAL INSURANCE AGE 50 AND UNDER)

ICR 198311-2900-005 · OMB 2900-0136 · Historical Active

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IC IDCollectionTypeStatusForm
147245 APPLICATION FOR REINSTATEMENT (NONMEDICAL INSURANCE AGE 50 AND UNDER) Form Migrated

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/1986 12/31/1986 07/31/1984
1,500 0 1,500
500 0 500
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
APPLICATION FOR REINSTATEMENT (NONMEDICAL INSURANCE AGE 50 AND UNDER) 29-353A

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,500 1,500 0 0 0 0
Annual Time Burden (Hours) 500 500 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
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