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: 0938-0787	ICR Reference No: 201007-0938-010
Status: Historical Active	Previous ICR Reference No: 200707-0938-004
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Request for Employment Information
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: 08/29/2010
	Date Received in OIRA: 07/22/2010
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2013	36 Months From Approved	09/30/2010
Responses	5,000	0	5,000
Time Burden (Hours)	1,250	0	1,250
Cost Burden (Dollars)	0	0	0

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