OMB control number

Consumer Operated and Oriented Plan [CO-OP] Program (CMS-10392)

OMB 0938-1139 · HHS/CMS.

OMB 0938-1139

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form CMS-10392 Updated Business Plans	Form and Instruction
Form CMS-10392 Core Contracts	Form and Instruction
Form CMS-10392 Disbursement Requests	Form and Instruction
Form CMS-10392 Request for additional funding	Form and Instruction
Form CMS-10392 Recordkeeping	Form and Instruction
Form CMS-10392 Audits	Form and Instruction
Form CMS-10392 Enhanced Reporting (Before Loan Repayment) - Start-up/Solvency Loan Recipients	Form and Instruction
Form CMS-10392 Standard Reporting After Loan Repayment - Start-up/Solvency Loan Recipients	Form and Instruction
Form CMS-10392 Standard Reporting Before Loan Repayment - Start-up/Solvency Loan(s) Recipients	Form and Instruction
Form CMS-10392 Loan Agreement Acceptance	Form and Instruction
Form CMS-10392 Reconsiderations & Appeals	Form and Instruction
Form CMS-10392 Start-up & Solvency Loan Application	Form and Instruction
CMS-10392 - PRA Comments and Response 5-29-15 v2.doc	Supplementary Document
CMS-10392 - Crosswalk 033015.xls	Supplementary Document
CMS-10392 - Supporting Statement 04012015 FINAL.pdf	Supporting Statement A
Updated Business Plans	Form and Instruction
Core Contracts	Form and Instruction
Disbursement Requests	Form and Instruction
Request for additional funding	Form and Instruction
Recordkeeping	Form and Instruction
Audits	Form and Instruction
Enhanced Reporting (Before Loan Repayment) - Start-up/Solvency Loan Recipients	Form and Instruction
Standard Reporting After Loan Repayment - Start-up/Solvency Loan Recipients	Form and Instruction
Standard Reporting Before Loan Repayment - Start-up/Solvency Loan(s) Recipients	Form and Instruction
Loan Agreement Acceptance	Form and Instruction
Reconsiderations & Appeals	Form and Instruction
Start-up & Solvency Loan Application	Form and Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Action
201504-0938-015	Revision of a currently approved collection	2015-04-28	Approved with change
201411-0938-013	Revision of a currently approved collection	2014-12-04	Approved with change
201201-0938-001	Extension without change of a currently approved collection	2012-01-03	Approved with change
201107-0938-015	No material or nonsubstantive change to a currently approved collection	2011-07-27	Approved without change
201107-0938-014	New collection (Request for a new OMB Control Number)	2011-07-26	Approved without change