Information Collection Request

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

ICR 202107-0938-006 · OMB 0938-1053 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10249 Maintenance of Effort (MOE) Form Form and Instruction Modified Available
Form CMS-10249 MFP_Budget_Workbook Form and Instruction Modified Available
Form CMS-64.9i, -64.9pi Quarterly Expenditures Form Modified Available
Form CMS-10249 MFP Financial Reporting Forms ABCD Form Modified Available
Form CMS-10249 Semi-Annual Progress Report Form Modified Available
Form CMS-10249 Administrative Requirements for Section 6071 of the DRA Form Modified Repair queued
CMS-10249 - Supporting Statement A (2021 version 5).docx Supporting Statement A Uploaded 2021-07-22 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
186838 Administrative Requirements for Section 6071 of the DRA Form and Instruction ModifiedMaintenance of Effort (MOE) Form
186838 Administrative Requirements for Section 6071 of the DRA Form and Instruction ModifiedMFP_Budget_Workbook
186838 Administrative Requirements for Section 6071 of the DRA Form ModifiedQuarterly Expenditures
186838 Administrative Requirements for Section 6071 of the DRA Form ModifiedMFP Financial Reporting Forms ABCD
186838 Administrative Requirements for Section 6071 of the DRA Form ModifiedSemi-Annual Progress Report
186838 Administrative Requirements for Section 6071 of the DRA Form Modified
186838 Administrative Requirements for Section 6071 of the DRA Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
08/31/2024 36 Months From Approved 12/31/2021
336 0 352
2,604 0 3,168
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, ,   ,   ,   ,  

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 336 352 0 -16 0 0
Annual Time Burden (Hours) 2,604 3,168 0 -564 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No