[Federal Register Volume 63, Number 142 (Friday, July 24, 1998)]
[Notices]
[Page 39881]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-19731]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[Document Identifier: HCFA-18F5]
Agency Information Collection Activities: Submission for OMB
Review; Comment Request
In compliance with the requirement of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the Health Care Financing
Administration (HCFA), Department of Health and Human Services, has
submitted to the Office of Management and Budget (OMB) the following
proposal for the collection of information. Interested persons are
invited to send comments regarding the burden estimate or any other
aspect of this collection of information, including any of the
following subjects: (1) the necessity and utility of the proposed
information collection for the proper performance of the agency's
functions; (2) the accuracy of the estimated burden; (3) ways to
enhance the quality, utility, and clarity of the information to be
collected; and (4) the use of automated collection techniques or other
forms of information technology to minimize the information collection
burden.
Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Application for
Hospital Insurance and Supporting Regulation 42CFR 406.7; Form No.:
HCFA-18F5, OMB # 0938-0251; Use: The HCFA 18F5 is used to establish
entitlement to hospital insurance and supplementary medical insurance
for beneficiaries entitled under title XVII of the Social Security Act
only. Frequency: One time submission; Affected Public: Individuals or
Households, Business or other for-profit, Not-for-profit institutions,
Farms, Federal Government, and State, Local or Tribal Government;
Number of Respondents: 50,000; Total Annual Responses: 50,000; Total
Annual Hours: 12,500.
To obtain copies of the supporting statement for the proposed
paperwork collections referenced above, E-mail your request, including
your address and phone number, to Paperwork@hcfa.gov, or call the
Reports Clearance Office on (410) 786-1326. Written comments and
recommendations for the proposed information collections must be mailed
within 30 days of this notice directly to the OMB Desk Officer
designated at the following address: OMB Human Resources and Housing
Branch, Attention: Allison Eydt, New Executive Office Building, Room
10235, Washington, D.C. 20503.
Dated: July 14, 1998.
John P. Burke III,
HCFA Reports Clearance Officer, HCFA, Office of Information Services,
Security and Standards Group, Division of HCFA Enterprise Standards.
[FR Doc. 98-19731 Filed 7-23-98; 8:45 am]
BILLING CODE 4120-03-P
