Information Collection List

IC Title	Status	Responses	Hours	Dollars	Document Type	Form No.
Alternative Benefit Plan (ABP)	New	56	728	0	Form and Instruction	CMS-10434
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CHIP Administration & Eligibility	New	56	1568	0	Form and Instruction	CMS-10434
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					Form and Instruction	CMS-10434
Initial Application	New	56	280	0	Instruction
					Form and Instruction	CMS-10434
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MACPro Home Page	New	56	28	0	Form	CMS-10434
Medicaid Administration	New	56	168	0	Instruction
					Form and Instruction	CMS-10434
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Total burden requested under this ICR:		280	2772	0
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