View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-0251	ICR Reference No: 199807-0938-015
Status: Historical Active	Previous ICR Reference No: 199503-0938-003
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Application for Hospital Insurance -- 42 CFR 406.7
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/21/1998
	Date Received in OIRA: 07/24/1998
Terms of Clearance: Approved for use through 9/2001 under the condition that HCFA immediately incorporates into the forms/instructions the new disclosure statements mandated by the Paperwork Reduction Act of 1995.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2001	09/30/2001
Responses	50,000	0	0
Time Burden (Hours)	12,500	0	0
Cost Burden (Dollars)	0	0	0

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