Claims and Payment Activities Report

Claims and Payment Activities Report

OMB: 1205-0010

IC ID: 120517

Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details

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Claims and Payment Activities Report
 
No Migrated
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 5159 Yes Yes


    

53 0
   
State, Local, and Tribal Governments
 
   98 %

  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 720 0 480 240 0 0
Annual IC Time Burden (Hours) 1,359 0 -318 -159 0 1,836
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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