Change of Ownership (Public)

Early Retiree Reinsurance Program

OMB: 0938-1087

IC ID: 192767

Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details

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Change of Ownership (Public)
 
No Modified
 
Required to Obtain or Retain Benefits
 
45 CFR 149.700

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

Health Health Care Services

 

27 0
   
State, Local, and Tribal Governments
 
   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 27 0 0 10 0 17
Annual IC Time Burden (Hours) 27 0 0 10 0 17
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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