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Coverage of Certain Preventive Services Under the Affordable Care Act-For-Profit Entities
OMB 1210-0152
OMB.report
DOL/EBSA
OMB 1210-0152
OMB 1210-0152
Latest Forms, Documents, and Supporting Material
Document
Name
Form EBSA Form 700 Self-Certification or Notification
Form
1210-0152final(2015-07-14).docx
Supporting Statement A
Self-Certification or Notification
Form
All Historical Document Collections
201506-1210-001
Approved without change
New collection (Request for a new OMB Control Number)
2015-07-14
201408-1210-003
Comment filed on proposed rule
New collection (Request for a new OMB Control Number)
2014-08-27
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