Justification for Nonsubstantive Change

_{This package sets out nonsubstantive changes to the Spanish version of our Appointment of Representative form (Nombramiento de un Representante). We are not making any changes to the English version or to any of our burden estimates.}

_{The Spanish version that was approved by OMB on November 6, 2015, contains inadvertent translation errors. We are correcting those errors in this nonsubstantive change request.}

_{Attachments (Form CMS-1696)}

_{-Clean - Nombramiento de un Representante}

_{-Crosswalk - Nombramiento de un Representante}

_{-Track Changes - Nombramiento de un Representante}