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Information Collection

Application for Help with Medicare Prescription Drug Plan Costs (Internet/Intranet Versions)

IC 9760 under ICR 200504-0960-003 · OMB 0960-0705.

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Information Collection (IC) Details

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Application for Help with Medicare Prescription Drug Plan Costs (Internet/Intranet Versions)
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form I1020 Yes Yes


    

2,000,000 0
   
Individuals or Households
 
   100 %

  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 2,000,000 0 2,000,000 0 0 0
Annual IC Time Burden (Hours) 1,500,000 0 1,500,000 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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