Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Application Requirements (POs) New 35 740 0 Form and Instruction CMS-10631
State Readiness Review (States) New 22 2640 0 Form and Instruction CMS-10631
Support of State Readiness Review (POs) New 22 1056 0 Form and Instruction CMS-10631
Waiver Requests (POs) New 5 100 0 Form and Instruction CMS-10631
Waiver Requests (States) New 5 40 0 Form and Instruction CMS-10631
Total burden requested under this ICR: 89 4576 0  
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