Information Collection

2014 882 CMS Medicare - 2014 891 Treasury Direct v2

IC 214140 under ICR 201110-1090-001 · OMB 1090-0008.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1090-0008 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 882 2014 882 CMS Medicare - 2014 891 Treasury Direct v2	Form and Instruction
882 2041 882 CMS Medicare 2014 882 CMS Medicare.xlsx	Form and Instruction
883 2014 883 DHS CIS Citizenship Resource Center 2014 883 DHS CIS Citizenship Resource Center.xlsx	Form and Instruction
884 2014 884 DoD Tricard 2014 884 DoD Tricare.xlsx	Form and Instruction
885 2014 885 HHS OCR 2014 885 HHS OCR.xlsx	Form and Instruction
886 2014 886 Maritime Administration 2014 886 Maritime Administration.xlsx	Form and Instruction
887 2014 887 NRC 2014 887 NRC.xlsx	Form and Instruction
888 2014 888 Recreation.gov 2014 888 Recreation.gov.xlsx	Form and Instruction
889 2014 889 Go4Life Mobile 2014 889 Go4Life Mobile.xlsx	Form and Instruction
890 2014 890 NHLBI 2014 890 NHLBI.xlsx	Form and Instruction
891 2014 891 TreasuryDirect v2 2014 891 TreasuryDirect v2.xlsx	Form and Instruction

IC Title:

2014 882 CMS Medicare - 2014 891 Treasury Direct v2

Agency IC Tracking Number:

882 - 891

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	882	2041 882 CMS Medicare	2014 882 CMS Medicare.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	883	2014 883 DHS CIS Citizenship Resource Center	2014 883 DHS CIS Citizenship Resource Center.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	884	2014 884 DoD Tricard	2014 884 DoD Tricare.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	885	2014 885 HHS OCR	2014 885 HHS OCR.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	886	2014 886 Maritime Administration	2014 886 Maritime Administration.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	887	2014 887 NRC	2014 887 NRC.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	888	2014 888 Recreation.gov	2014 888 Recreation.gov.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	889	2014 889 Go4Life Mobile	2014 889 Go4Life Mobile.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	890	2014 890 NHLBI	2014 890 NHLBI.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	891	2014 891 TreasuryDirect v2	2014 891 TreasuryDirect v2.xlsx	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 36,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	36,000	36,000
Annual IC Time Burden (Hours)	1,500	1,500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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