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View ICR - OIRA Conclusion

OMB Control No: 0938-0035	ICR Reference No: 197712-0938-005
Status: Historical Active	Previous ICR Reference No: 197710-0938-001
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: REPORT OF STATE-IN PROBLEM
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR: No
Type of Review Request: Emergency	Approval Requested By: 12/06/1977
OIRA Conclusion Action: Approved with change	Conclusion Date: 12/06/1977
	Date Received in OIRA: 12/06/1977
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/1982	09/30/1982	09/30/1982
Responses	50,000	0	600,000
Time Burden (Hours)	12,500	0	150,000
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	50,000	600,000	-550,000
Annual Time Burden (Hours)	12,500	150,000	-137,500
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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