Document
Form CMS-R-0235A
ICR 202505-0938-012 · OMB 0938-0734 · Object 158261401.
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Queue: Repair is in progress, but the document is still incomplete and remains in the worker queue. (priority 80 · next 2026-06-25 06:39:31)
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Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | Form CMS-R-0235A |
| Author | Rebecca Dorman |
| File Created | 2026-01-02 |
| Conversion State | partial |