Contractors Information Collections - Sole Community Provider Exemption Requests

CONTRACTORS INFORMATION COLLECTIONS - SOLE COMMUNITY PROVIDER EXEMPTION REQUESTS

OMB: 0938-0229

IC ID: 113185

Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details

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CONTRACTORS INFORMATION COLLECTIONS - SOLE COMMUNITY PROVIDER EXEMPTION REQUESTS
 
No Migrated
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HCFA-9041 No No


    

80 0
   
Private Sector Businesses or other for-profits
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 80 0 0 80 0 0
Annual IC Time Burden (Hours) 80 0 0 80 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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