View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-0086	ICR Reference No: 200510-0938-001
Status: Historical Active	Previous ICR Reference No: 200207-0938-013
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: 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: 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: 12/07/2005
	Date Received in OIRA: 10/06/2005
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2008	12/31/2008	12/31/2005
Responses	125,000	0	125,000
Time Burden (Hours)	62,500	0	62,500
Cost Burden (Dollars)	0	0	0

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