Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Expanded Monitoring Site Review: Beneficiary Interview Form Modified 21772 3629 0 Form SSA-639 Expanded Monitoring Site Review Beneficiary Review Form
Other-Revised PA Statement
Site Review Questionnaires for Volume and Fee-for-Service Payees Modified 4924 9848 0 Form SSA-637 Expanded Monitoring Site Review Questionnaire for Volume and Fee for Service Payees
Other-Revised PA Statement
Total burden requested under this ICR: 26696 13477 0  
To view an IC, click on IC Title