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

View Information Collection (IC)

Bundle: #7 (CHIPRA Cycle III and IV), #39 (Learning Collaboratives), and #40 (BIPP Template; formerly, CMS-10411, OCN 0938-1145)
 
New
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-10398 (#7) Yes Yes Fillable Printable
Form CMS-10398 (#7) Yes Yes Fillable Printable
Other-39 State Selection Memo No   Paper Only
Form CMS-10398 (#39) Yes Yes Fillable Printable
Form CMS-10398 (#39) Yes Yes Fillable Printable
Form CMS-10398 (#39) Yes Yes Fillable Printable
Form CMS-10398 (#39) Yes Yes Fillable Printable
Form CMS-10398 (#39) Yes Yes Fillable Printable
Form CMS-10398 (#40) Yes Yes Fillable Printable

Health Health Care Services

 

35 0
   
State, Local, and Tribal Governments
 
   100 %

  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 127 0 127 0 0 0
Annual IC Time Burden (Hours) 1,867 0 1,867 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
#7 Supporting Statement 04/15/2015
39 Supporting Statement 04/15/2015
40 Supporting Statement 04/15/2015
Bundled GenIC Burden Table 04/15/2015
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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