Information Collection Request
COVID–19 Provider Relief Programs Single and Commercial Audits and Delinquent Audit Reporting Submission Activities
ICR 202403-0906-005 · OMB 0906-0083 · Active
⚠️ Notice: This information collection may be outdated.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 | Modified | Available |
| Form 2 Delinquent Audit Follow-up Email and Attestation |
Form and Instruction | Modified | Available |
| Form 1 PRF Commercial Audit Form |
Form and Instruction | Unchanged | Repair queued |
 OMB NonSubstantive Change Request_DFI CARD PRA_3-15-24.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2024-03-19 | Available |
 02012024 Provider Relief Program Emergency Clearance Memo_Final.pdf |
Supplementary Document | Uploaded 2024-02-08 | Available |
| OFAM Supporting Statement A_Revised.docx |
Supporting Statement A | Uploaded 2024-02-08 | Available |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 264092 |  Provider Relief Fund (PRF) Questioned Cost Attestation Form |
Form and Instruction | Modified | |
| 264091 | Delinquent Audit Follow-up Email and Attestation |
Form and Instruction | Modified | |
| 264090 | Delinquent Audit Follow-up General Email Blast |
Instruction | Unchanged | |
| 264089 | Commercial Audit Compliance Email |
Instruction | Unchanged | |
| 264088 | PRF Commercial Audit Form |
Form and Instruction | Unchanged |
ICR Details
| Status | Active |
|---|---|
| Agency/Subagency | HHS/HRSA |
| OMB Control No | 0906-0083 |
| Type of Information Collection | No material or nonsubstantive change to a currently approved collection |
| Previous ICR Reference No | 202312-0906-003 |
| Date Submitted to OIRA | 2024-03-21 |
| Requested Expiration Date | 2024-01-31 |