Information Collection

Survey of newly-insured plans 2008

IC 186780 under ICR 200610-1212-002 · OMB 1212-0053.

Information Collection (IC) Details

View Information Collection (IC)

layout table

Information Collection Instruments:
table that charts list of instruments
Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction no number Questionnaire 1212-0053 Questionnaire for Newly Insured Plans.doc Yes No Printable Only

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  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 400 0 0 0 0 0
Annual IC Time Burden (Hours) 100 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
OMB-PBGC Q&A - November 2008 - Newly Insured Plans 1212-0053 QandA Questionnaire for Newly Insured Plans.doc 11/21/2008
Questionnaire for Newly Insured Plans - Initial Version 1212-0053 Letter to PAs and Questionnaire - First Version.doc 11/21/2008
Supporting Statement - Final Version 1212-0053 Supporting Statement.doc 11/21/2008
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.