Information Collection Request

Annual Report for Multiple Employer Welfare Arrangements (Form M-1)

ICR 201208-1210-002 · OMB 1210-0116 · Historical Inactive

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IC IDCollectionTypeStatusForm
13484 Annual Report for Multiple Employer Welfare Arrangements and Certain Entities Claiming Exception (Form M-1) Modified

ICR Details

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table that charts list comparision
  Inventory as of this Action Requested Previously Approved
02/29/2016 36 Months From Approved 03/31/2013
484 0 464
130 0 62
91,996 0 44,000





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Annual Report for Multiple Employer Welfare Arrangements and Certain Entities Claiming Exception (Form M-1) M-1

table that charts list of burden
  Total Request 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 484 464 19 1 0 0
Annual Time Burden (Hours) 130 62 65 3 0 0
Annual Cost Burden (Dollars) 91,996 44,000 45,596 2,400 0 0


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