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

View Information Collection (IC)

Exemption Applications - Eligibility for Exemptions
 
No Modified
 
Required to Obtain or Retain Benefits
 
45 CFR 155.610 45 CFR 155.615 45 CFR 155.620 45 CFR 155.625

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10466 Yes No Fillable Printable
Form and Instruction CMS-10466 Yes No Fillable Printable
Form and Instruction CMS-10466 Yes No Fillable Printable
Form and Instruction CMS-10466 Yes No Fillable Printable
Form and Instruction CMS-10466 Yes No Fillable Printable
Form and Instruction CMS-10466 Yes No Fillable Printable
Form and Instruction CMS-10466 Yes No Fillable Printable

Health Health Care Services

 

12,000,000 0
   
Individuals or Households
 
   90 %

  Approved 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 12,000,000 0 0 0 0 12,000,000
Annual IC Time Burden (Hours) 3,240,000 0 0 0 0 3,240,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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