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Information Collection

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

IC 113969 under ICR 199411-0938-005 · OMB 0938-0553.

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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


    

1 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 46 0 46 0 0 0
Annual IC Time Burden (Hours) 126 0 126 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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