Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Appointment of Representative and Supporting Regulations in 42 CFR 405.910 Modified 5455461 6819 0 Form and Instruction CMS-1696 English APPOINTMENT??OF??REPRESENTATIVE
Form and Instruction CMS--1696 SP NOMBRAMIENTO DE REPRESENTANTE
Total burden requested under this ICR: 5455461 6819 0  
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