Information Collection Request
Annual Report for Multiple Employer Welfare Arrangements
ICR 202108-1210-003 · OMB 1210-0116 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1210-0116 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form Form M-1 Annual Report for Multiple Employer Welfare Arrangements and Certain Entities Claiming Exception (Form M-1) |
Form and Instruction | Modified | Repair queued |
 1210-0116 ss21 9-15-21.docx |
Supporting Statement A | Uploaded 2021-09-15 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 13484 |  Annual Report for Multiple Employer Welfare Arrangements and Certain Entities Claiming Exception (Form M-1) |
Form and Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | DOL/EBSA |
| OMB Control No | 1210-0116 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 201904-1210-004 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |