Information Collection Requirements For The Third Party Liability (tpl) Action Plan As Provided For In Bqc-64

INFORMATION COLLECTION REQUIREMENTS FOR THE THIRD PARTY LIABILITY (TPL) ACTION PLAN AS PROVIDED FOR IN BQC-64

OMB: 0938-0553

IC ID: 113968

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INFORMATION COLLECTION REQUIREMENTS FOR THE THIRD PARTY LIABILITY (TPL) ACTION PLAN AS PROVIDED FOR IN BQC-64
 
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-R-123 No No


    

50 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 50 0 0 50 0 0
Annual IC Time Burden (Hours) 126 0 0 126 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.

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