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

View Information Collection (IC)

Home & Community Based Waiver Requests and Supporting Regulations; 42 CFR 440.180, 441.300-.310
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR 441.300-310 42 CFR 440.180

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-8003 Yes Yes Fillable Fileable
Instruction No   Printable Only

Health Health Care Services

 

49 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 71 0 0 0 71 0
Annual IC Time Burden (Hours) 6,005 0 0 0 6,005 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Crosswalk - Waiver Application 09/24/2020
Crosswalk - Application Instructions, Technical Guide, and Review Criteria 09/24/2020
            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.