Disclosure Statement for Section 5004

Disclosure Statement for Section 5004.DOC

Recovery Act - Reporting Requirements for States Under FMAP Increase and TMA Provisions (CMS-10295)

Disclosure Statement for Section 5004

OMB: 0938-1073

Document [doc]
Download: doc | pdf

PRA Disclosure Statement





According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0938-XXXX. The time required to complete this information collection is estimated to average

2 hours per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland 21244-1850.




























File Typeapplication/msword
File TitleAccording to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it
AuthorHCFA Software Control
Last Modified ByCMS
File Modified2009-09-16
File Created2009-09-16

© 2024 OMB.report | Privacy Policy