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Payment of Premiums (29 CFR part 4007)
OMB: 1212-0009
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OMB 1212-0009
ICR 202210-1212-002
IC 13518
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⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1212-0009 can be found here:
2023-11-06 - Extension without change of a currently approved collection
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