View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-0086	ICR Reference No: 199311-0938-008
Status: Historical Active	Previous ICR Reference No: 199108-0938-010
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: 02/20/1994
	Date Received in OIRA: 11/22/1993
Terms of Clearance: Approved for use through 8/94 under the condition that HCFA thoroughly addresses OMB's clearance remarks dated 11/27/91.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/1994	08/31/1994	11/30/1993
Responses	40,000	0	40,000
Time Burden (Hours)	20,000	0	20,000
Cost Burden (Dollars)	0	0	0

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