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: 0938-0988	ICR Reference No: 201612-0938-006
Status: Historical Active	Previous ICR Reference No: 201309-0938-030
Agency/Subagency: HHS/CMS	Agency Tracking No: CMS-10180
Title: Children's Health Insurance Program (CHIP) Report on Payables and Receivables
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: 05/10/2017
	Date Received in OIRA: 12/28/2016
Terms of Clearance: Prior to use, the OMB control number and expiration date must be added to the online form.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2020	36 Months From Approved	05/31/2017
Responses	56	0	56
Time Burden (Hours)	392	0	392
Cost Burden (Dollars)	0	0	0

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