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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 202508-1210-001
IC 13476
( )
Documents and Forms
Document Name
Document Type
1210-0113 NMSN Part B 2.9.25.docx
Other-National Medical Support Notic
PartB_Reference_To_Addendum 2.9.25.docx
Other-National Medical Support Notic
e-NMSN__Addendum 2.9.25.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:
Modified
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 and Addendum
1210-0113 NMSN Part B 2.9.25.docx
Yes
No
Fillable Fileable
Other-National Medical Support Notice
PartB_Reference_To_Addendum 2.9.25.docx
Yes
Yes
Fillable Fileable
Other- Addendum
e-NMSN__Addendum 2.9.25.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:
399,269
Number of Respondents for Small Entity:
386,570
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
53 %
Requested
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
10,753,708
0
0
-8,598,579
0
19,352,287
Annual IC Time Burden (Hours)
896,142
0
0
-319,516
0
1,215,658
Annual IC Cost Burden (Dollars)
5,927,982
0
0
-472,787
0
6,400,769
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.