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Provider Relief Fund (PRF) Questioned Cost Attestation Form
COVID–19 Provider Relief Programs Single and Commercial Audits and Delinquent Audit Reporting Submission Activities
OMB: 0906-0083
IC ID: 264092
OMB.report
HHS/HRSA
OMB 0906-0083
ICR 202312-0906-003
IC 264092
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0906-0083 can be found here:
2024-03-21 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 3
Provider Relief Fund (PRF) Questioned Cost Attestation Form
Form and Instruction
3 Provider Relief Fund (PRF) Questioned Cost Attestation Form
Questioned Cost Attestation Form_Final .docx
Form and Instruction
Information Collection (IC) Details
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