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National Medical Support Notice - Part B
National Medical Support Notice-Part B
OMB: 1210-0113
IC ID: 13476
OMB.report
DOL/EBSA
OMB 1210-0113
ICR 202102-1210-001
IC 13476
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0113 can be found here:
2022-09-26 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
1210_0113 National Medical Support Notice Part B 12-4-2019.docx
Other-National Medical Support Notic
1210_0113 National Medical Support Notice Part B 12-4-2019.docx
Other-National Medical Support Notic
PartB_Reference_To_Addendum.docx
Other-National Medical Support Notic
PartB_Reference_To_Addendum.docx
Other-National Medical Support Notic
e-NMSN__Addendum 5 18 20.docx
Other-Addendum
e-NMSN__Addendum 5 18 20.docx
Other-Addendum
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
National Medical Support Notice - Part B
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Mandatory
CFR Citation:
29 CFR 2590.609-2
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-National Medical Support Notice
1210_0113 National Medical Support Notice Part B 12-4-2019.docx
Yes
No
Fillable Fileable
Other-National Medical Support Notice
PartB_Reference_To_Addendum.docx
Yes
Yes
Fillable Fileable
Other-Addendum
e-NMSN__Addendum 5 18 20.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
425,444
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
48 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
10,546,371
0
0
0
0
10,546,371
Annual IC Time Burden (Hours)
878,864
0
0
0
0
878,864
Annual IC Cost Burden (Dollars)
3,322,107
0
0
0
0
3,322,107
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.