COVID–19 Provider Relief Programs Single and Commercial Audits and Delinquent Audit Reporting Submission Activities

ICR 202408-0906-002

OMB: 0906-0083

Federal Form Document

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0906-0083 can be found here:

2025-05-14 - No material or nonsubstantive change to a currently approved collection

Forms and Documents

Document Name	Status
Form 3 Provider Relief Fund (PRF) Questioned Cost Attestation Form Form and Instruction	Modified
Form 2 Delinquent Audit Follow-up Email and Attestation Form and Instruction	Modified
Form 1 PRF Commercial Audit Form Form and Instruction	Modified
OMB NonSubstantive Change Request_DFI CARD PRA_3-15-24.docx Justification for No Material/Nonsubstantive Change	2024-03-19
02012024 Provider Relief Program Emergency Clearance Memo_Final.pdf Supplementary Document	2024-02-08
Supporting Statement A - COVID 19 PRF Audits - Revision - 08152024.docx Supporting Statement A	2024-08-15

IC Document Collections

IC ID	Document Title	Status
264092	Provider Relief Fund (PRF) Questioned Cost Attestation Form Form and Instruction	Modified
264091	Delinquent Audit Follow-up Email and Attestation Form and Instruction	Modified
264090	Delinquent Audit Follow-up General Email Blast Instruction	Modified
264089	Commercial Audit Compliance Email Instruction	Modified
264088	PRF Commercial Audit Form Form and Instruction	Modified

ICR Details

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