Medicare Advantage & Part D Disenrollment Requests Through 1-800-MEDICARE

OMB 0938-0741

OMB 0938-0741
Latest Forms, Documents, and Supporting Material
Document
Name
Supplementary Document
Supplementary Document
Supporting Statement A
All Historical Document Collections
Approved with change
 Revision of a currently approved collection 2008-11-04
Approved without change
 Extension without change of a currently approved collection 2005-10-26
Approved without change
 Extension without change of a currently approved collection 2002-10-30
Approved without change
 Extension without change of a currently approved collection 1999-01-28
Approved without change
 New collection (Request for a new OMB Control Number) 1998-09-22
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