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3 Revised Questioned Cost Attestation Form
COVID–19 Provider Relief Programs Single and Commercial Audits and Delinquent Audit Reporting Submission Activities
Questioned Cost Attestation Form_Final Revised 3-15-24 Clean
Provider Relief Fund (PRF) Questioned Cost Attestation Form
OMB: 0906-0083
OMB.report
HHS/HRSA
OMB 0906-0083
ICR 202403-0906-005
IC 264092
3 Revised Questioned Cost Attestation Form
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0906-0083 can be found here:
2024-08-15 - Revision of a currently approved collection
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File Title
P4 Reconsiderations Form Template V5 1-27-2022.docx.pdf
Author
EWilliams1
File Modified
0000-00-00
File Created
2024-07-22
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