View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-0086	ICR Reference No: 199711-0938-001
Status: Historical Active	Previous ICR Reference No: 199604-0938-003
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Medicare/Medicaid Disclosure of Ownership and Financial Control Interest Statement and Supporting Regulations Contained in 42 CFR 420.200-.206 and 455.100-.106
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: 01/02/1998
	Date Received in OIRA: 11/04/1997
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/1999	07/31/1999
Responses	92,000	0	0
Time Burden (Hours)	46,000	0	0
Cost Burden (Dollars)	0	0	0

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