View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Annual Notice of Change (ANOC) and Evidence of Coverage (EOC)
 
No Modified
 
Mandatory
 
42 CFR 422.111(a)(3) 42 CFR 423.128(a)(3)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction Yes No Fillable Printable
Instruction Yes No Fillable Printable
Instruction Yes No Fillable Printable
Instruction Yes No Fillable Printable
Instruction Yes No Fillable Printable
Instruction Yes No Fillable Printable
Instruction Yes No Fillable Printable
Instruction Yes No Fillable Printable
Instruction Yes No Fillable Printable
Instruction No   Fillable Fileable
Instruction No   Fillable Fileable
Instruction No   Fillable Fileable
Instruction No   Fillable Fileable
Instruction No   Fillable Fileable
Instruction No   Fillable Fileable
Instruction No   Fillable Fileable
Instruction No   Fillable Fileable
Instruction No   Fillable Fileable
Instruction No   Fillable Fileable
Instruction No   Fillable Fileable
Instruction No   Fillable Fileable
Instruction No   Fillable Fileable
Instruction No   Fillable Fileable
Instruction No   Fillable Fileable
Instruction No   Fillable Fileable
Instruction No   Fillable Fileable
Instruction No   Fillable Fileable

Health Health Care Services

 

805 0
   
Private Sector Businesses or other for-profits
 
   0 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 805 0 0 0 0 805
Annual IC Time Burden (Hours) 9,660 0 0 0 0 9,660
Annual IC Cost Burden (Dollars) 8,068,730,000 0 0 8,068,730,000 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.