Justification for Nonsubstantive Change

Justification [07-16-2015 OSORA PRA].docx

Appointment of Representative and Supporting Regulations in 42 CFR 405.910 (CMS-1696)

Justification for Nonsubstantive Change

OMB: 0938-0950

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This package sets out nonsubstantive changes.


Specifically, the changes consist of adding a Spanish version of the form. To save money (translation costs), the form was translated after we received OMB approval of the English version.


We have also corrected the number of provider/supplier respondents which are correct in the currently approved Supporting Statement, but were entered into ROCIS incorrectly.


366,656 respondents (see Supporting Statement approved on June 22, 2015)

-366,565 respondents (see provider/supplier burden approved on June 22, 2015)

+91 respondents (provider/supplier)






File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorMitch Bryman
File Modified0000-00-00
File Created2021-01-24

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