Quarterly Children's Health Insurance Program Statement of Expenditures for Title XXI

Quarterly Children's Health Insurance Program Statement of Expenditures for Title XXI

OMB: 0938-0731

IC ID: 8398

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Quarterly Children's Health Insurance Program Statement of Expenditures for Title XXI
 
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-21 Yes Yes
Form HCFA-21B Yes Yes


    

56 0
   
State, Local, and Tribal Governments
 
   100 %

  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 448 0 0 0 0 448
Annual IC Time Burden (Hours) 7,840 0 0 0 0 7,840
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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