Information Collection Request

Certificate of Delivery of Advance Payment and Enrollment

ICR 201603-2900-012 · OMB 2900-0325 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 22-1999v Certificate of Delivery of Advance Payment and Enrollment Form Modified Available
WHITE PAPER on Non Substantial Change For Expiration Date.docx Justification for No Material/Nonsubstantive Change Uploaded 2016-03-18 Repair queued
Supporting Statement [3]-updated.doc Supporting Statement A Uploaded 2013-07-30 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
28544 Certificate of Delivery of Advance Payment and Enrollment Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2016 09/30/2016 09/30/2016
700 0 700
58 0 58
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Certificate of Delivery of Advance Payment and Enrollment 22-1999v Certificate of Delivery of Advance Payment and Enrollment

table that charts list of burden
  Total Approved 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 700 700 0 0 0 0
Annual Time Burden (Hours) 58 58 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No