Information Collection Request

Form 2587--Application for Special Enrollment Examination

ICR 201805-1545-015 · OMB 1545-0949 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 2587 Form 2587--Application for Special Enrollment Examination Form and Instruction Modified Available
2018-09-11_SS_1545-0949rSC.docx Supporting Statement A Uploaded 2018-10-23 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
39887 Form 2587--Application for Special Enrollment Examination Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2021 36 Months From Approved 12/31/2018
11,000 0 11,000
1,100 0 11,000
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Form 2587--Application for Special Enrollment Examination 2587 Application for Special Enrollment Examination

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 11,000 11,000 0 0 0 0
Annual Time Burden (Hours) 1,100 11,000 0 0 -9,900 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No