OMB control number

Coverage of Certain Preventive Services Under the Affordable Care Act - Private Sector

OMB 1545-2307 · TREAS/IRS.

OMB 1545-2307

Latest Forms, Documents, and Supporting Material

Document Name
Supporting Statement IRS.docx Supporting Statement A
Confirmation of Eligibility for the Individual Contraceptive Arrangement
Notice of Availability of Separate Payments for Contraceptive Services
Self-Certification or Notification to HHS

All Historical Document Collections

202210-1545-017

2023-02-02