Information Collection

Application for Special Enrollment Examination

IC 39887 under ICR 201307-1545-016 · OMB 1545-0949.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-0949 can be found here:

Documents and Forms

Document Name Document Type
Form 2587 Application for Special Enrollment Examination Form and Instruction
2587 Application for Special Enrollment Examination Form 2587.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Special Enrollment Examination	Agency IC Tracking Number:	ah-0949-038

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 5 CFR 1320.8(b)(3) 5 CFR 1320.9

Information Collection Instruments:

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	Form 2587.pdf		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 11,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	11,000	11,000
Annual IC Time Burden (Hours)	11,000	11,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.