Information Collection Request
ICR 201409-0505-001 · OMB 0505-0024 · Public filing
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0505-0024 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form DPRS 2809 Request to Change FEHB Enrollment or to Receive Plan Brochures for Spouse Equity/Temporary Continuation of Coverage Enrollees/Direct Pay Annuitants |
Form and Instruction | Modified | Available |
 2011 Markups.pdf |
Supplementary Document | Uploaded 2011-10-11 | Available |
 0505-0024 - 2014 - DPRS2809 SuppStmt.doc |
Supporting Statement A | Uploaded 2014-10-30 | Available |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 33692 |  Request to Change FEHB Enrollment or to Receive Plan Brochures for Spouse Equity/Temporary Continuation of Coverage Enrollees/Direct Pay Annuitants |
Form and Instruction | Modified |
ICR Details
| OMB Control No | 0505-0024 |
|---|