View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-0202	ICR Reference No: 198910-0938-002
Status: Historical Active	Previous ICR Reference No: 198708-0938-011
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: HOME OFFICE COST STATEMENT
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/02/1990
	Date Received in OIRA: 10/27/1989
Terms of Clearance: Approved for use through 12/90 under the condition that the next submission for OMB approval includes a representative sample of alternative home office cost statements and respective instructions accepted and used by HCFA contractors. In addition, the next form and manual instructions must incorporate the burden disclosure statement as required by 5 CFR 1320.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/1990	12/31/1990
Responses	850	0	0
Time Burden (Hours)	396,100	0	0
Cost Burden (Dollars)	0	0	0

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