Information Collection Request
Certificate of Coverage Request
ICR 202210-0960-001 · OMB 0960-0554 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0960-0554 can be found here:
Forms and Documents
Document Name | Status |
|---|---|
Supporting Statement A | 2022-12-14 |
Supporting Statement - 0554 (Final).docxIC Document Collections
| IC ID | Document Title | Status | |
|---|---|---|---|
| 9477 | Modified | ||
| 222537 | Modified | ||
| 222536 | Modified | ||
| 222535 | Modified | ||
| 222534 | Modified | ||
| 206903 | Modified | ||
| 206902 | Modified | ||
| 206901 | Modified | ||
| 206899 | Modified | ||
| 206898 | Modified | ||
| 206897 | Modified | ||
| 182116 | Modified |
Certificate of Coverage Request via Letter - Individuals (minus Denmark, Iceland, Netherlands, Norway, Slovenia, Sweden & Uruguay)ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | SSA |
| OMB Control No | 0960-0554 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 201905-0960-002 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |