Information Collection

Annual Report on Home and Community-Based Services Waivers

IC 7925 under ICR 199511-0938-006 · OMB 0938-0272.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0272 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Annual Report on Home and Community-Based Services Waivers	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HCFA-372(S)				No	No
Form	HCFA-372				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 49	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	200	73	127
Annual IC Time Burden (Hours)	18,000	7,938	10,062
Annual IC Cost Burden (Dollars)	555,000,000	555,000,000	0

Documents for IC

Title	Document	Date Uploaded

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