View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-0086	ICR Reference No: 198903-0938-005
Status: Historical Active	Previous ICR Reference No: 198605-0938-001
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: MEDICARE/MEDICAID - DISCLOSURE OF OWNERSHIP AND CONTROL INTEREST STATEMENT
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/11/1989
	Date Received in OIRA: 03/20/1989
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/1991	05/31/1991	06/30/1989
Responses	30,000	0	30,000
Time Burden (Hours)	15,000	0	15,000
Cost Burden (Dollars)	0	0	0

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