Information Collection Request
COVID–19 Provider Relief Programs Single and Commercial Audits and Delinquent Audit Reporting Submission Activities
ICR 202312-0906-003 · OMB 0906-0083 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0906-0083 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form 3 Provider Relief Fund (PRF) Questioned Cost Attestation Form |
Form and Instruction | New | Missing upstream |
| Form 2 Delinquent Audit Follow-up Email and Attestation |
Form and Instruction | New | Repair queued |
| Form 1 PRF Commercial Audit Form |
Form and Instruction | New | Repair queued |
 DFI CARD PRA Supporting Statement A_V2.docx |
Supporting Statement A | Uploaded 2023-12-28 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 264092 |  Provider Relief Fund (PRF) Questioned Cost Attestation Form |
Form and Instruction | New | |
| 264091 | Delinquent Audit Follow-up Email and Attestation |
Form and Instruction | New | |
| 264090 | Delinquent Audit Follow-up General Email Blast |
Instruction | New | |
| 264089 | Commercial Audit Compliance Email |
Instruction | New | |
| 264088 | PRF Commercial Audit Form |
Form and Instruction | New |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/HRSA |
| OMB Control No | 0906-0083 |
| Type of Information Collection | New collection (Request for a new OMB Control Number) |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 2024-01-31 |