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Annual Report On Waivers For Home And Community Based Services

IC 113300 under ICR 198210-0938-003 · OMB 0938-0268.

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ANNUAL REPORT ON WAIVERS FOR HOME AND COMMUNITY BASED SERVICES
 
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-371 & No No
Form HCFA-372 No No


    

40 0
   
State, Local, and Tribal Governments
 
   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 80 0 0 0
Annual IC Time Burden (Hours) 12,160 0 12,160 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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