OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Request to the Department of Labor for Expedited Review of Denial of COBRA Premium Reduction

OMB 1210-0135 · DOL/EBSA.

OMB 1210-0135

Latest Forms, Documents, and Supporting Material

Document Name
Form Form 301 Additional Information Request to Plan Administrator Form and Instruction
Form Form 300 Request to the Department of Labor for Expedited Review of Denial of COBRA Premium Reduction Form and Instruction
Expedited_Review_of_Denial_of_Claims_ss12[1].docx Supporting Statement A
Additional Information Request to Plan Administrator Form and Instruction
Request to the Department of Labor for Expedited Review of Denial of COBRA Premium Reduction Form and Instruction

All Historical Document Collections

201210-1210-002 Approved without change	Extension without change of a currently approved collection	2012-11-27
201004-1210-006 Approved without change	No material or nonsubstantive change to a currently approved collection	2010-04-21
201003-1210-001 Approved without change	No material or nonsubstantive change to a currently approved collection	2010-03-16
201001-1210-003 Approved without change	No material or nonsubstantive change to a currently approved collection	2010-01-20
200909-1210-003 Approved without change	Extension without change of a currently approved collection	2009-09-24
200903-1210-002 Approved without change	New collection (Request for a new OMB Control Number)	2009-04-29