OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Coverage of Certain Preventive Services Under the Affordable Care Act-For-Profit Entities

OMB 1210-0152 ยท DOL/EBSA.

OMB 1210-0152

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form EBSA Form 700 Self-Certification or NotificationForm
1210-0152final(2015-07-14).docxSupporting Statement A
Self-Certification or Notification Form

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
201506-1210-001 New collection (Request for a new OMB Control Number) 2015-07-14 Approved without change
201408-1210-003 New collection (Request for a new OMB Control Number) 2014-08-27 Comment filed on proposed rule