Information Collection

Preprinted State Plans In Place As Of September 1981, And "transmittal And Notice Of Approval Of State Plan Material" (hcfa-179)

IC 113064 under ICR 198109-0938-004 · OMB 0938-0193.

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Information Collection (IC) Details

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IC Title:	PREPRINTED STATE PLANS IN PLACE AS OF SEPTEMBER 1981, AND "TRANSMITTAL AND NOTICE OF APPROVAL OF STATE PLAN MATERIAL" (HCFA-179)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HCFA-179				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 54	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	648	108	540
Annual IC Time Burden (Hours)	1,236	966	270
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.