Information Collection

Periodic Eligibility Renewals (§§ 435.916, 457.343, and 457.350)

IC 281606 under ICR 202606-0938-016 · OMB 0938-1147.

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IC Title:

Periodic Eligibility Renewals (§§ 435.916, 457.343, and 457.350)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 435.916, 457.343, and 457.350

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 25,500,096

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	96,300,096	96,300,096
Annual IC Time Burden (Hours)	29,501,741	29,501,741
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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