View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-0787	ICR Reference No: 201609-0938-023
Status: Historical Active	Previous ICR Reference No: 201401-0938-002
Agency/Subagency: HHS/CMS	Agency Tracking No: CM-CPC
Title: Request for Employment Information (CMS-R-297/CMS-L564)
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 with change	Conclusion Date: 02/01/2017
	Date Received in OIRA: 09/29/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/29/2020	36 Months From Approved	01/31/2017
Responses	15,000	0	15,000
Time Burden (Hours)	5,000	0	5,000
Cost Burden (Dollars)	0	0	0

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