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Application For Consideration Of Home In The Community Care Program

IC 146935 under ICR 198204-2900-001 · OMB 2900-0081.

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APPLICATION FOR CONSIDERATION OF HOME IN THE COMMUNITY CARE PROGRAM
 
No Migrated
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 10-2407 No No


    

1,000 0
   
Individuals or Households
 
   0 %

  Requested 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 1,000 0 0 1,000 0 0
Annual IC Time Burden (Hours) 333 0 0 333 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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