Document
Model Employer CHIP Notice (State, Local, Tribal Governmental Burden)
ICR 201909-1210-008 · OMB 1210-0137 · Object 94905201.
This document may belong to an older filing. More recent activity for OMB 1210-0137:
Document Viewer [doc]
Status: The document is viewable, but some background extraction is still pending.
Queue: Repair is queued and waiting for the next worker pass. (priority 70 · next 2026-06-25 23:09:23)
Missing: html
Download: Source copy (doc)
Loading document viewer…
Document Metadata
| File Type | application/msword |
|---|---|
| File Title | Model Employer CHIP Notice (State, Local, Tribal Governmental Burden) |
| Author | Tamara A. Mihailovic |
| Last Modified By | Mulhall, Tamara - EBSA |
| File Modified | 2016-09-08 |
| File Created | 2016-09-08 |
| Conversion State | partial |