Payment of Premiums (29 CFR part 4007)

ICR 202508-1212-004

OMB: 1212-0009

Federal Form Document

Forms and Documents

Document Name	Status
Form Premium Filing Payment of Premiums (29 CFR part 4007) Form	Modified
Form Premium Filing Payment of Premiums (29 CFR part 4007) Form	Modified
1212-0009 Supporting Statement 2025.06.docx Supporting Statement A	2025-08-25
1212-0009 Supporting Statement 2025.06.docx Supporting Statement A	2025-08-25
Justification of non-material changes Premium Filing 2024.04.docx Justification for No Material/Nonsubstantive Change	2024-12-20
Justification of non-material changes Premium Filing 2024.04.docx Justification for No Material/Nonsubstantive Change	2024-12-20

IC Document Collections

IC ID	Document Title	Status
13518	Payment of Premiums (29 CFR part 4007) Form	Modified
13518	Payment of Premiums (29 CFR part 4007) Form	Modified