Information Collection Request

Grants to States for Health Insurance Premium Review

ICR 201007-0938-014 · OMB 0938-1092 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
193933 Transaction Data Collection New
193172 Quarterly Reports Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
01/31/2011 6 Months From Approved 12/31/2010
360 0 51
8,640 0 26,520
0 0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Quarterly Reports CMS-10323
Transaction Data Collection CMS-10323

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 360 51 309 0 0 0
Annual Time Burden (Hours) 8,640 26,520 -17,880 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No