Supporting Statement 83-C Request
CMS-1696
We are submitting the Spanish version of the form CMS-1696 (OMB 0938-0950) for OMB approval. This form is an exact translation of the most recently OMB approved English version of the collection instrument. The form historically has been made available in both English and Spanish. We have received approval for the English version and are now seeking approval for the identical Spanish counterpart version so that both collection instruments may be made available to the public. There are no changes to the burden, this is a non-material/ non-substantive change to a currently approved collection.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Additional Information For Paperwork Reduction Act Submissions |
| Author | H2N9 |
| File Modified | 0000-00-00 |
| File Created | 2021-02-02 |