Application for Special Enrollment Examination

Application for Special Enrollment Examination

OMB: 1545-0949

IC ID: 39887

Documents and Forms
Information Collection (IC) Details

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Application for Special Enrollment Examination ah-0949-038
 
No Modified
 
Required to Obtain or Retain Benefits
 
5 CFR 1320.9 5 CFR 1320.8(b)(3)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 2587 Application for Special Enrollment Examination 2010form.pdf No   Paper Only

General Government Taxation Management

 

11,000 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 11,000 0 0 0 0 11,000
Annual IC Time Burden (Hours) 11,000 0 0 0 0 11,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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