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

View Information Collection (IC)

RIF Request Packet CMS-R-235
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-R-235 Yes Yes Fillable Fileable
Form and Instruction CMS-R-235 Yes Yes Fillable Fileable
Form and Instruction CMS-R-235 Yes Yes Fillable Fileable
Form and Instruction CMS-R-235 Yes Yes Fillable Fileable
Form and Instruction CMS-R-235 Yes Yes Fillable Fileable
Form and Instruction CMS-R-235 Yes Yes Fillable Fileable
Form and Instruction CMS-R-235 Yes Yes Fillable Fileable
Form and Instruction CMS-R-235 Yes Yes Fillable Fileable

Health Health Care Services

 

3,455 0
   
Private Sector Not-for-profit institutions
 
   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 3,455 0 750 0 0 2,705
Annual IC Time Burden (Hours) 1,624 0 375 0 0 1,249
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Track Change - RIF Application 05/27/2025
Track Change - RIF Amendment 05/27/2025
RIF Amendment_JobAid 05/27/2025
RIF Application_JobAid 05/27/2025
RIF Extension Request_JobAid 05/27/2025
RIF Signature Addendum_JobAid 05/27/2025
IT system - Data collection fields 05/29/2025
            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.