Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Data Files Submission New 320 320 0 Form and Instruction Form #4
Data Use Agreement Modified 60 3 0 Form and Instruction Form #2
Health Plan Information Modified 320 160 0 Form and Instruction Form #3
Registration Form and Data Submission Modified 80 7 0 Form and Instruction Form #1
Total burden requested under this ICR: 780 490 0  
To view an IC, click on IC Title