Information Collection

Supplemental Appropriations Act of 2008 Mandated Report to Congress (CMS-10281)

IC 188980 under ICR 200904-0938-015 · OMB 0938-1061.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10281 Supplemental Appropriations Act of 2008 Mandated Report to Congress (CMS-10281)	Form and Instruction
CMS-10281 Mandated Report to Congress Independent Study and Report CMS-10281 Lewin Draft Interview Questions for Reg Research Study 4-9-09.DOC	Form and Instruction
CMS-10281 Emergency PRA Justification.DOC CMS-10281 Emergency PRA Justification	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form?

IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10281	Mandated Report to Congress Independent Study and Report	CMS-10281 Lewin Draft Interview Questions for Reg Research Study 4-9-09.DOC		No	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 51

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	51	51
Annual IC Time Burden (Hours)	3,060	3,060
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
CMS-10281 Emergency PRA Justification	CMS-10281 Emergency PRA Justification.DOC	04/10/2009

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