View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-0723	ICR Reference No: 199912-0938-005
Status: Historical Active	Previous ICR Reference No: 199803-0938-009
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Medicare Integrity Program Organizational Conflict of Interest Disclosure Certificate and Supporting Regulations at 42 CFR 421.310 and 421.312
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: 02/22/2000
	Date Received in OIRA: 12/21/1999
Terms of Clearance: Approved for use through 2/2001 consistent with OMB's prior clearance remarks.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2001	04/30/2001	02/29/2000
Responses	10	0	15
Time Burden (Hours)	2,400	0	3,000
Cost Burden (Dollars)	0	0	0

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