IDR Entity Certification and IDR Entity Monthly Reporting

No Surprises Act: IDR Process

OMB: 1210-0169

IC ID: 248857

Documents and Forms
Document Name
Document Type
Other-IDR Certification Application
Other-IDR Certification Application
Other-Notice of Petition for Denial
Other-Notice of Petition for Denial
Other-Monthly IDR Entity Reporting R
Other-Monthly IDR Entity Reporting R
Other-SDRE Determination Notice
Other-SDRE Determination Notice
Other-SDRE Confirmation of Receipt o
Other-SDRE Confirmation of Receipt o
Other-SDRE Selection Notice
Other-SDRE Selection Notice
Other-SDRE Entity Certification Data
Other-SDRE Entity Certification Data
Other-SDRE Declining Eligibility or
Other-SDRE Declining Eligibility or
Other-Certified IDR Entity Written D
Other-Certified IDR Entity Written D
Information Collection (IC) Details

View Information Collection (IC)

IDR Entity Certification and IDR Entity Monthly Reporting
 
Yes Modified
 
Mandatory
 
29 CFR 2590

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-IDR Certification Application 7. Tri-dept - IDR certification application (data elements) clean 9.28.21.docx Yes Yes Fillable Printable
Other-Notice of Petition for Denial or Revocation 8. Tri-dept - notice of petition for certification denial or revocation clean 9.28.21.docx Yes Yes Fillable Printable
Other-Monthly IDR Entity Reporting Requirements 9. Tri-dept - monthly IDR entity reporting requirements (data elements) clean 9.28.21.docx Yes Yes Fillable Printable
Other-SDRE Determination Notice 8. PPDR SDRE Determination Notice.docx Yes Yes Fillable Printable
Other-SDRE Confirmation of Receipt of Settlement Information 5. Appendix-SDR Entity Certification Data Elements.docx Yes Yes Fillable Printable
Other-SDRE Selection Notice 9. PPDR SDRE Selection Notice.docx Yes Yes Fillable Printable
Other-SDRE Entity Certification Data Elements 12. Appendix-SDRE Confirmation of Receipt of Settlement Notice.docx Yes Yes Fillable Printable
Other-SDRE Declining Eligibility or Need More Information 3. SDRE Declining Eligibility or Need More Information Notice.docx Yes Yes Fillable Printable
Other-Certified IDR Entity Written Determination 11. Tri-dept - Certified IDR Entity Written Determination (Data Elements) 4.20.22 clean .docx Yes Yes Fillable Printable

Income Security General Retirement and Disability

 

25 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  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 170 0 0 85 0 85
Annual IC Time Burden (Hours) 0 0 0 0 0 0
Annual IC Cost Burden (Dollars) 33,217 0 0 11,082 0 22,135

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.

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