View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 0938-0935	ICR Reference No: 200707-0938-002
Status: Historical Active	Previous ICR Reference No: 200612-0938-009
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Medicare Advantage Applications - Part C
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: 01/11/2008
	Date Received in OIRA: 07/13/2007
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2011	36 Months From Approved	01/31/2008
Responses	220	0	220
Time Burden (Hours)	5,580	0	5,580
Cost Burden (Dollars)	0	0	0

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Medicare Advantage Applications	CMS-10214, CMS-10117, CMS-10136, CMS-10118, CMS-10119, CMS-10135	, , , , ,

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