View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0960-0267	ICR Reference No: 201408-0960-008
Status: Historical Active	Previous ICR Reference No: 201112-0960-003
Agency/Subagency: SSA	Agency Tracking No:
Title: Medicaid Use Report
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/22/2014
	Date Received in OIRA: 11/03/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2017	36 Months From Approved	03/31/2015
Responses	60,000	0	60,000
Time Burden (Hours)	3,000	0	3,000
Cost Burden (Dollars)	0	0	0

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