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Model Employer Children's Health Insurance Program Notice
ICR 202211-1210-002
OMB: 1210-0137
Federal Form Document
OMB.report
DOL/EBSA
OMB 1210-0137
ICR 202211-1210-002
( )
Forms and Documents
Document
Name
Status
1210-0137 CHIPRA Model Notice 12-14-2022 Clean.docx
Supporting Statement A
2022-12-14
IC Document Collections
IC ID
Document
Title
Status
208807
Model Employer CHIP Notice (State, Local, Tribal Governmental Burden)
Other-Model Notice
Modified
191695
Model Employer CHIP Notice (Private Sector Burden)
Other-Model Notice
Modified
ICR Details
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