CONTRACTORS' INFORMATION COLLECTION - "MACHINE READABLE CLAIMS"

ICR 198112-0938-005

OMB: 0938-0225

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0938-0225 198112-0938-005
Historical Active
HHS/CMS
CONTRACTORS' INFORMATION COLLECTION - "MACHINE READABLE CLAIMS"
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 12/19/1981
Retrieve Notice of Action (NOA) 12/01/1981
  Inventory as of this Action Requested Previously Approved
04/30/1983 04/30/1983
27,220 0 0
20,415 0 0
0 0 0

THESE INTERMEDIARY/CARRIER FORMS SURVEY PROVIDERS/SUPPLIERS ON THEIR CAPABILITY TO SUBMIT MACHINE-READABLE DATA. THERE ARE ALSO TRANSMITTA FORMS WHICH ACCOMPANY THE DATA, AND FORMS REQUESTING HARD-COPY SUBSTANTIATION.

None
None


No

1
IC Title Form No. Form Name
CONTRACTORS' INFORMATION COLLECTION - "MACHINE READABLE CLAIMS" HCFA-9037

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 27,220 0 0 0 27,220 0
Annual Time Burden (Hours) 20,415 0 0 0 20,415 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
12/01/1981


© 2024 OMB.report | Privacy Policy