Letter Requesting Waiver of Medicare/Medicaid Enrollment Application Fee; Submission of Fingerprints; Submission of Medicaid Identifying Information; Medicaid Site Visit and Rescreening (CMS-10357)

OMB 0938-1137

OMB 0938-1137
Latest Forms, Documents, and Supporting Material
Document
Name
Supplementary Document
Supplementary Document
Supporting Statement A
All Historical Document Collections
Approved with change
 Reinstatement without change of a previously approved collection 2014-10-03
Approved with change
 New collection (Request for a new OMB Control Number) 2011-03-01
Comment filed on proposed rule
 New collection (Request for a new OMB Control Number) 2010-10-20
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