Information Collection Request
Medicare Registration Application (CMS-855O)
ICR 202301-0938-008 · OMB 0938-1135 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1135 can be found here:
Forms and Documents
Document Name | Status |
|---|---|
Form and Instruction |
Modified |
Form and Instruction |
Modified |
Form and Instruction |
Modified |
Supporting Statement A | 2023-01-20 |
Form CMS-855O Reporting Voluntary Withdrawal of Registration Information
CMS-855O - Supporting statement - 30-dayf.docxIC Document Collections
| IC ID | Document Title | Status | |
|---|---|---|---|
| 202856 | Modified | ||
| 197862 | Modified | ||
| 197861 | Modified |
Reporting Voluntary Withdrawal of Registration InformationICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-1135 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202201-0938-006 |
| Agency Tracking No | CPI |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |