Information Collection Requirements Contained in BDP-718: Advanced Directives (Medicare and Medicaid) and Supporting Regulations in 42 CFR Sections 417.436, 417.801, 422.128,....

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Information Collection (IC) Details

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IC Title:	Information Collection Requirements Contained in BDP-718: Advanced Directives (Medicare and Medicaid) and Supporting Regulations in 42 CFR Sections 417.436, 417.801, 422.128,....	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HCFA-R-10				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 34,365	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	34,365	-1,540	35,905
Annual IC Time Burden (Hours)	960,500	52,250	908,250
Annual IC Cost Burden (Dollars)	0	0	0

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