Information Collection Request

Application for Accreditation as a Claims Agent or Attorney

ICR 200712-2900-011 · OMB 2900-0605 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 21A Application for Accreditation as a Claims Agent or Attorney Form Modified Available
2900-0605 justification .DOC Supporting Statement A Uploaded 2007-12-13 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
28847 Application for Accreditation as a Claims Agent or Attorney Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
05/31/2011 36 Months From Approved 06/30/2008
137 0 20
103 0 15
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Application for Accreditation as a Claims Agent or Attorney 21A Application for Accreditation as a Claims Agent or Attorney

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 137 20 0 117 0 0
Annual Time Burden (Hours) 103 15 0 88 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No