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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Appointment of Representative (Beneficiary)
Modified
34728
8682
0
Form and Instruction
CMS-1696
Nombramiento de un Representante
Form and Instruction
CMS-1696
Appointment of Representative (English)
Appointment of Representative (Provider Supplier)
Modified
312556
78139
0
Form and Instruction
CMS-1696
Nombramiento de un Representante
Form and Instruction
CMS-1696
Appointment of Representative (English)
Total burden requested under this ICR:
347284
86821
0
To view an IC, click on IC Title