Standard Reporting Before Loan Repayment - Start-up/Solvency Loan(s) Recipients

Consumer Operated and Oriented Plan [CO-OP] Program

OMB: 0938-1139

IC ID: 198653

Information Collection (IC) Details

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Standard Reporting Before Loan Repayment - Start-up/Solvency Loan(s) Recipients
 
No Modified
 
Required to Obtain or Retain Benefits
 
45 CFR 156

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10392 CO-OP FOA CMS-10392.CO-OP FOA (12-9-11).pdf Yes Yes Fillable Fileable
Form and Instruction CMS-10392 Reporting Templates CMS-10392.CO-OP Reporting Template.docx Yes Yes Fillable Fileable

Health Health Care Services

 

51 51
   
Private Sector Not-for-profit institutions
 
   98 %

  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 612 0 0 0 0 612
Annual IC Time Burden (Hours) 11,628 0 0 0 0 11,628
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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