Interstate TRS Fund | ||||||
Additional Costs Paid to Provider for Calendar Year 2017 | ||||||
Jurisdiction | Service Type | Provider | Rate Start Date | Rate End Date | Amount | Description |
January--2018 | |||||||||||
Approved by OMB | |||||||||||
OMB Control number 3060-1249 | |||||||||||
See instructions for public burden estimate | |||||||||||
If you have questions about the content of these forms, please contact: | Bob Loube | [email protected] | 301-681-0338 | ||||||||
Please send this completed workbook by February 20, 2018 to: | [email protected] | 717-585-6605 |
File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
File Modified | 0000-00-00 |
File Created | 0000-00-00 |