Information Collection

Home and Community-Based Waiver Requests and Supporting Regulation -- 42 CFR 440.180, 441.300-.310

IC 8070 under ICR 199901-0938-007 · OMB 0938-0449.

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Information Collection (IC) Details

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IC Title:	Home and Community-Based Waiver Requests and Supporting Regulation -- 42 CFR 440.180, 441.300-.310	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-8003				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	128	-12	140
Annual IC Time Burden (Hours)	7,860	-340	8,200
Annual IC Cost Burden (Dollars)	0	-263,130,000	263,130,000

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.