OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

HIV/AIDS Bureau Core Medical Services Waiver

IC 181012 under ICR 201910-0915-002 · OMB 0915-0307.

Documents and Forms
Document Name
Document Type
Instruction
Information Collection (IC) Details

View Information Collection (IC)

HIV/AIDS Bureau Core Medical Services Waiver
 
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 Form.Core Medical Services Waiver Application (2).docx Yes Yes Fillable Fileable

Health Health Care Services

 

20 0
   
State, Local, and Tribal Governments
 
   100 %

  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 20 0 0 0 0 20
Annual IC Time Burden (Hours) 110 0 0 0 0 110
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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