Provider Enrollment Form

OMB 1215-0137

OMB 1215-0137

Latest Forms, Documents, and Supporting Material

Document Name
Form OWCP-1168 Provider Enrollment Form Form
SS 1215-0137 SS 9-24-2009 final[1][1].doc Supporting Statement A
Provider Enrollment Form Form

All Historical Document Collections

200906-1215-001 Approved without change	Extension without change of a currently approved collection	2009-10-06
200610-1215-005 Approved without change	Extension without change of a currently approved collection	2006-11-08
200506-1215-005 Approved without change	No material or nonsubstantive change to a currently approved collection	2005-06-29
200312-1215-004 Approved without change	Extension without change of a currently approved collection	2003-12-17
200301-1215-005 Approved without change	Revision of a currently approved collection	2003-01-16
200112-1215-004 Approved without change	Revision of a currently approved collection	2001-12-19
200107-1215-005 Approved without change	No material or nonsubstantive change to a currently approved collection	2001-07-06
199812-1215-002 Approved without change	Extension without change of a currently approved collection	1998-12-01
199512-1215-002 Approved without change	Extension without change of a currently approved collection	1995-12-07
199212-1215-001 Approved without change	Revision of a currently approved collection	1992-12-28
198912-1215-002 Approved without change	Revision of a currently approved collection	1989-12-18
198704-1215-003 Approved without change	Reinstatement with change of a previously approved collection	1987-04-09
198404-1215-001 Approved without change	Revision of a currently approved collection	1984-04-05
198309-1215-039 Approved with change	No material or nonsubstantive change to a currently approved collection	1983-09-06
198205-1215-002 Approved without change	New collection (Request for a new OMB Control Number)	1982-05-28

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