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5. Tri-dept - notice of agreement of OON rate (data elements) clean 9.28.21
No Surprises Act: IDR Process
5. Tri-dept - notice of agreement of OON rate (data elements) clean 9.28.21
OMB: 1210-0169
OMB.report
DOL/EBSA
OMB 1210-0169
ICR 202202-1210-002
IC 249676
5. Tri-dept - notice of agreement of OON rate (data elements) clean 9.28.21
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⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1210-0169 can be found here:
2023-11-03 - Revision of a currently approved collection
2023-02-24 - RCF Recertification
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