Request To Change Fehb Enrollment Or To Receive Plan Brochures

REQUEST TO CHANGE FEHB ENROLLMENT OR TO RECEIVE PLAN BROCHURES

OMB: 3206-0202

IC ID: 157105

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REQUEST TO CHANGE FEHB ENROLLMENT OR TO RECEIVE PLAN BROCHURES
 
No Migrated
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form DPRS 2809 No No


    

15,000 0
   
Individuals or Households
 
   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 15,000 0 0 0 0 15,000
Annual IC Time Burden (Hours) 2,500 0 0 0 0 2,500
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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