OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Fall COVID-19 Supplement

IC 242742 under ICR 202007-0938-005 · OMB 0938-1379.

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

View Information Collection (IC)

Fall COVID-19 Supplement
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction P-0015A COVID-19 Community Supplement Attachment 2. MCBS Fall 2020 COVID-19 Community Supplement.docx Yes Yes Fillable Fileable
Form and Instruction P-0015A COVID-19 Facility Supplement Attachment 3. MCBS Fall 2020 COVID-19 Facility Supplement_clean.docx Yes Yes Fillable Fileable

Health Health Care Services

Medicare Current Beneficiary Survey (MCBS)  83 FR 6591

11,536 0
   
Individuals or Households
 
   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 11,536 11,536 0 0 0 0
Annual IC Time Burden (Hours) 2,884 2,884 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.