Information Collection Request

COVID-19 Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Payment Reporting Activities

ICR 202210-0906-003 · OMB 0906-0068 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1 COVID-19 Provider Relief Fund (PRF) Reporting Activities Form Modified Repair queued
PRF Reporting Activities - Supporting Statement FINAL.docx Supporting Statement A Uploaded 2022-10-31 Repair queued
PRF Reporting Activities - 5 Provider Post-Payment-Notice of Reporting Requirements - October 2022.pdf Supplementary Document Uploaded 2022-10-27 Missing upstream
PRF Reporting Activities - 2 Burden Hour Justification Formula.docx Supplementary Document Uploaded 2022-10-27 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
250697 COVID-19 Provider Relief Fund (PRF) Reporting Activities Form Modified

ICR Details

Record metadata
Received in OIRA
HHS/HRSA
0906-0068
Revision of a currently approved collection
202112-0906-001
1969-12-31
1969-12-31