270 form

HHS Payment Management System Forms PMS-270 - Request for Advance or Reimbursement and PMS-272 - Federal Cast Transaction Report

Documents and Forms

Document Name Document Type
Form 270 270 form Form
270 Request for advance Reimbursement PSC 270 blank form.pdf Form

Information Collection (IC) Details

IC Title:	270 form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 31 CFR 205

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	270	Request for advance Reimbursement	PSC 270 blank form.pdf		No	No	Paper Only

Line of Business: General Government

Subfunction: Central Personnel

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 210	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,520	2,520
Annual IC Time Burden (Hours)	630	630
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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