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

View Information Collection (IC)

Bundle: #13 (UPL 1), #24 (UPL 2), and #46 (1915(i) State Plan Home and Community Based Services)
 
New
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction Yes Yes Paper Only
Form CMS-10398 (#13) Yes Yes Fillable Fileable
Instruction Yes Yes Paper Only
Form CMS-10398 (#13) Yes Yes Fillable Fileable
Instruction Yes Yes Paper Only
Form CMS-10398 (#13) Yes Yes Fillable Fileable
Form and Instruction CMS-10398 (#13) Yes Yes Fillable Fileable
Form and Instruction CMS-10398 (#13) Yes Yes Fillable Fileable
Form and Instruction CMS-10398 (#13) Yes Yes Fillable Fileable
Instruction Yes Yes Paper Only
Form CMS-10398 (#24) Yes Yes Fillable Fileable
Instruction Yes Yes Paper Only
Form CMS-10398 (#24) Yes Yes Paper Only
Instruction Yes Yes Paper Only
Form CMS-10398 (#24) Yes Yes Paper Only
Instruction Yes Yes Paper Only
Instruction Yes Yes Paper Only
Form CMS-10398 (#24) Yes Yes Paper Only
Form and Instruction CMS-10398 (#24) Yes Yes Fillable Fileable
Form and Instruction CMS-10398 (#24) Yes Yes Fillable Fileable
Form and Instruction CMS-10398 (#24) Yes Yes Fillable Fileable
Form and Instruction CMS-10398 (#24) Yes Yes Fillable Fileable
Form and Instruction CMS-10398 (#24) Yes Yes Fillable Fileable
Form CMS-10398 (#46) Yes Yes Fillable Fileable

Health Health Care Services

 

9 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 9 0 9 0 0 0
Annual IC Time Burden (Hours) 1,026 0 1,026 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
#13 - Supporting Statement 11/10/2016
#24 - Supporting Statement 11/10/2016
#46 - Supporting Statement 11/10/2016
Bundle Burden Summary 11/10/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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