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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Authorization Form on behalf of Claimant under 42 CFR 83.7
Modified
3
0
0
Instruction
Form A 42 CFR 83.9
Modified
2
0
0
Instruction
Form B 42 CFR Part 83.9
Modified
5
25
0
Form
none
Form B
Petitioner Appealing Final Decision under 42 CFR 83.18
Modified
2
10
0
Instruction
Petitioner Submission Format other than Form B 42 CFR 83.9
Unchanged
1
6
0
Instruction
Total burden requested under this ICR:
13
41
0
To view an IC, click on IC Title