PSRO GRANT APPLICATION AND INSTRUCTIONS

ICR 198204-0938-016

OMB: 0938-0087

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
112834 Migrated
ICR Details
0938-0087 198204-0938-016
Historical Active 198003-0938-002
HHS/CMS
PSRO GRANT APPLICATION AND INSTRUCTIONS
Revision of a currently approved collection   No
Regular
Approved without change 06/24/1982
Retrieve Notice of Action (NOA) 04/27/1982
  Inventory as of this Action Requested Previously Approved
12/31/1982 12/31/1982 05/31/1982
146 0 195
21,900 0 38,000
0 0 0

THE PSRO GRANT APPLICATION IS REQUIRED FOR THE PURPOSES OF COLLECTING CRUCIAL INFORMATION FROM AN ORGANIZATION ON THEIR OPERATIONAL METHODOLOGIES TO DETERMINE IF THAT ORGANIZATION CAN SATISFACTORILY CARRY OUT THE GOALS OF THE PSRO PROGRAM AND HENCE RECEIVE FEDERAL DOLLARS FOR THAT PURPOSE.

None
None


No

1
IC Title Form No. Form Name
PSRO GRANT APPLICATION AND INSTRUCTIONS HCFA-95-98,, 103-109,, & 174

  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 146 195 0 -49 0 0
Annual Time Burden (Hours) 21,900 38,000 0 -16,100 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes

$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.
04/27/1982


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