OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Electronic Funds Transfer Authorization Agreement (CMS-588)

ICR 202305-0938-005 · OMB 0938-0626 · Received in OIRA

Forms and Documents
Document
Name
Status
Form and Instruction
 Modified
Supporting Statement A
2023-05-11
Supplementary Document
2023-05-10
IC Document Collections
IC ID
Document
Title
Status
43660 Modified
ICR Details
StatusReceived in OIRA
Agency/SubagencyHHS/CMS
OMB Control No0938-0626
Type of Information CollectionRevision of a currently approved collection
Previous ICR Reference No201912-0938-021
Agency Tracking NoCPI - 588
Date Submitted to OIRA1969-12-31
Requested Expiration Date1969-12-31