Application

Preliminary Establishment for Territories Cooperative Agreements for the Affordable Care Act Exchanges

OMB: 0938-1118

IC ID: 195957

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Application
 
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Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability

Health Health Care Services

 

5 0
   
State, Local, and Tribal Governments
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 5 5 0 0 0 0
Annual IC Time Burden (Hours) 2,315 2,315 0 0 0 0
Annual IC Cost Burden (Dollars) 112,177 112,177 0 0 0 0

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