PACE State Plan Option Preprint (CMS-10227)

PACE State Plan Amendment Pre-print (CMS-10227)

OMB: 0938-1027

IC ID: 181912

Information Collection (IC) Details

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PACE State Plan Option Preprint (CMS-10227)
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction SMDL-11-09-00.tif No No Printable Only
Form CMS-10227 PACE State Plan Amendment Pre-Print CMS-10227 SPA PACE PREPRINT [rev 06-14-2017 by OSORA PRA].pdf Yes Yes Fillable Printable

Health Health Care Services

 

21 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 7 0 0 0 0 7
Annual IC Time Burden (Hours) 140 0 0 0 0 140
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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