View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 0938-0723	ICR Reference No: 200208-0938-002
Status: Historical Active	Previous ICR Reference No: 200101-0938-004
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Medicare Integrity Program Organizational Conflict of Interest Disclosure Certificate and Supporting Regultions at 42 CFR 421.300 - 421.318
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/17/2002
	Date Received in OIRA: 08/05/2002
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2005	10/31/2005	10/31/2002
Responses	5	0	10
Time Burden (Hours)	1,000	0	2,400
Cost Burden (Dollars)	0	0	0

Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.