Information Collection Request

Administrative Requirements for Section 6071 of the Deficit Reduction Act of 2005 (CMS-10249)

ICR 201807-0938-002 · OMB 0938-1053 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10249 Administrative Requirements for Section 6071 of the DRA (CMS-10249) Form Modified Available
CMS-10249 - Supporting Statement A (rev 09-07-2018 by OSORA PRA).doc Supporting Statement A Uploaded 2018-09-10 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
186838 Administrative Requirements for Section 6071 of the DRA (CMS-10249) Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2021 36 Months From Approved
352 0 0
3,168 0 0
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Administrative Requirements for Section 6071 of the DRA (CMS-10249) CMS-10249, CMS-10249, CMS-10249, CMS-10249, CMS-64.9i, -64.9pi, -64.10i, and -64.910pi, MFP Semi-Annual Report ,   Annual Financial Forms for Existing Grantees ,   MFP Financial Reporting Forms ABCD ,   Additional Benchmarks – Addendum to the MFP Semi-Annual Progress Report ,   Quarterly Expenditures

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 352 0 0 -8 -28,215 28,575
Annual Time Burden (Hours) 3,168 0 0 408 -11,460 14,220
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No