Information Collection

Establishing Creditable Coverage

IC 38420 under ICR 200412-1210-003 · OMB 1210-0103.

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Information Collection (IC) Details

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IC Title:	Establishing Creditable Coverage	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

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

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,600,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	21,000,000	-23,396,000	44,396,000
Annual IC Time Burden (Hours)	260,000	-91,150	351,150
Annual IC Cost Burden (Dollars)	18,500,000	-16,189,000	34,689,000

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.