View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-0270	ICR Reference No: 201309-0938-011
Status: Historical Active	Previous ICR Reference No: 200709-0938-010
Agency/Subagency: HHS/CMS	Agency Tracking No: 20494
Title: The Financial Statement of Debtor and Supporting Regulations in 42 CFR, Section 405.376
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: 02/14/2014
	Date Received in OIRA: 09/12/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2017	36 Months From Approved
Responses	500	0	0
Time Burden (Hours)	1,000	0	0
Cost Burden (Dollars)	0	0	0

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