View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-0035	ICR Reference No: 197802-0938-004
Status: Historical Active	Previous ICR Reference No: 197712-0938-005
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: 02/01/1978
OIRA Conclusion Action: Approved with change	Conclusion Date: 02/01/1978
	Date Received in OIRA: 02/01/1978
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/1979	01/31/1979	09/30/1982
Responses	50,000	0	50,000
Time Burden (Hours)	12,500	0	12,500
Cost Burden (Dollars)	0	0	0

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