Opt-in State Balance Bill Process

OMB 1210-0168

Latest Forms, Documents, and Supporting Material

Document Name
1210-0168 State Opt-in Balance Bill Process 3-21-2025.docx Supporting Statement A
No-Surprises-Act (1).pdf Supplementary Document
Opt-In State Balance Bill Process

All Historical Document Collections

202411-1210-002	Extension without change of a currently approved collection	2025-04-02
202202-1210-004 Approved without change	Extension without change of a currently approved collection	2022-03-15
202108-1210-012 Approved with change	New collection (Request for a new OMB Control Number)	2021-08-24