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

Document Name
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All Historical Document Collections

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