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View ICR - OIRA Conclusion

OMB Control No: 0938-0379	ICR Reference No: 198408-0938-004
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: HOSPICE SURVEY REPORT FORM
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/07/1984
	Date Received in OIRA: 08/06/1984
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/1987	09/30/1987
Responses	53	0	0
Time Burden (Hours)	1,200	0	0
Cost Burden (Dollars)	0	0	0

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