Information Collection Request

Grants to States for Health Insurance Premium Review

ICR 201008-0938-017 · 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
194415 Application - Cycle I re-release New
193933 Transaction Data Collection Modified
193172 Quarterly Reports Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
02/28/2011 6 Months From Approved 01/31/2011
458 0 360
15,952 0 8,640
0 0 0





Reginfo record details
3
table that charts list of burden
IC Title Form No. Form Name
Quarterly Reports CMS-10323
Transaction Data Collection CMS-10323
Application - Cycle I re-release 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 458 360 0 98 0 0
Annual Time Burden (Hours) 15,952 8,640 0 7,312 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No