[Federal Register Volume 63, Number 99 (Friday, May 22, 1998)]
[Notices]
[Page 28394]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-13676]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration
[Document Identifier: HCFA-18F5]


Agency information Collection Activities: Proposed Collection; 
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, is 
publishing the following summary of proposed collections for public 
comment. 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 P[email protected], or call the 
Reports Clearance Office on (410) 786-1326. Written comments and 
recommendations for the proposed information collections must be mailed 
within 60 days of this notice directly to the HCFA Paperwork Clearance 
Officer designated at the following address: HCFA, Office of 
Information Services, Information Technology Investment Management 
Group, Division of HCFA Enterprise Standards Attention: John Rudolph 
Room C2-26-17 7500 Security Boulevard Baltimore, Maryland 21244-1850

    Dated: May 14, 1998.
John P. Burke III,
HCFA Reports Clearance Officer, Division of HCFA Enterprise Standards, 
Health Care Financing Administration.
[FR Doc. 98-13676 Filed 5-21-98; 8:45 am]
BILLING CODE 4120-03-P