State Children's Health Insurance Program and Supporting Regulations in 42 CFR 431.636, 457.50, 457.60, 457.70, 457.340, 457.350, 457.431, 457.440, 457.525, 457.560,...

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Information Collection (IC) Details

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IC Title:	State Children's Health Insurance Program and Supporting Regulations in 42 CFR 431.636, 457.50, 457.60, 457.70, 457.340, 457.350, 457.431, 457.440, 457.525, 457.560,...	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 42 CFR 431.636 42 CFR 457.50 42 CFR 457.60 42 CFR 457.70 42 CFR 457.340 42 CFR 457.350 42 CFR 457.431 42 CFR 457.440 42 CFR 457.525 42 CFR 457.560 42 CFR 457.570 42 CFR 457.740 42 CFR 457.750 42 CFR 457.810 42 CFR 457.940 42 CFR 457.945 42 CFR 457.965 42 CFR 457.985 42 CFR 457.1005 42 CFR 457.1015 42 CFR 457.1180

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 56	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,114,124	1,114,124
Annual IC Time Burden (Hours)	864,973	864,973
Annual IC Cost Burden (Dollars)	0	0

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.