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Information Collection

Enhanced Reporting (Before Loan Repayment) - Start-up/Solvency Loan Recipients

IC 198655 under ICR 201504-0938-015 · OMB 0938-1139.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Enhanced Reporting (Before Loan Repayment) - Start-up/Solvency Loan Recipients
 
No Modified
 
Required to Obtain or Retain Benefits
 
45 CFR 156

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10392 Reporting Templates CMS-10392.CO-OP Reporting Template.docx Yes Yes Fillable Fileable
Form and Instruction CMS-10392 CO-OP FOA CMS-10392_CO-OP_FOA_(final).pdf Yes Yes Fillable Fileable
Form and Instruction CMS-10392 Monthly Reporting Guidance CMS-10392 - Monthly Reporting Guidance 04012015 FINAL.PDF Yes Yes Fillable Fileable
Form and Instruction CMS-10392 Monthly Reporting Template CMS-10392 - Monthly reporting template 04012015 FINAL.pdf - Adobe Acro....pdf Yes Yes Fillable Fileable
Form and Instruction CMS-10392 Semi-Annual Reporting Template CMS-10392 - Semi-Annual Report.accdb Yes Yes Fillable Fileable
Form and Instruction CMS-10392 Quarterly Financial Report CMS-10392 - CO-OP Program Quarterly Financial Report Access Database 9-21-12 (2).mpp Yes Yes Fillable Fileable

Health Health Care Services

 

10 10
   
Private Sector Not-for-profit institutions
 
   98 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 20 0 0 0 0 20
Annual IC Time Burden (Hours) 60 0 0 0 0 60
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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