Medicare Request for Retirement Benefit Information (CMS-R-285)

ICR 202408-0938-005

OMB: 0938-0769

Federal Form Document

Forms and Documents

Document Name	Status
Form CMS-R-285 Request for Retirement Benefit Informatin Form	Modified
CMS-R-285 - Supporting Statement A_.docx Supporting Statement A	2024-08-07
Response to Comments OMB 0938 0769.docx Supplementary Document	2024-08-06
Crosswalk of Changes CMS R285_508.pdf Supplementary Document	2024-08-06
Justification - Use of SSN.docx Supplementary Document	2013-09-08

IC Document Collections

IC ID	Document Title	Status
8511	Request for Retirement Benefit Informatin Form	Modified