Contractors Information Collections-hcfa Regional Office Program Integrity Forms To Verify Services

CONTRACTORS INFORMATION COLLECTIONS-HCFA REGIONAL OFFICE PROGRAM INTEGRITY FORMS TO VERIFY SERVICES

OMB: 0938-0204

IC ID: 113097

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no available documents/forms check other ICs listed under this ICR
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CONTRACTORS INFORMATION COLLECTIONS-HCFA REGIONAL OFFICE PROGRAM INTEGRITY FORMS TO VERIFY SERVICES
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HCFA-9011 No No


    

30,000 0
   
Individuals or Households
 
   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 30,000 0 0 28,600 0 1,400
Annual IC Time Burden (Hours) 15,000 0 0 14,300 0 700
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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