OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Parts C and D Complaints Resolution Performance Measures (CMS-10308)

IC 193233 under ICR 201208-0938-003 · OMB 0938-1107.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Parts C and D Complaints Resolution Performance Measures (CMS-10308)
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10308 CMS-10308.Revised Survey Instrument CMS-10308.Revised Survey Instrument.doc No No Paper Only
Form and Instruction CMS-10308 Parts C and D Complaint Closure Beneficiary Survey CR_OMB SurveyInstrument 100520.pdf No No Paper Only
Form and Instruction CMS-10308 Parts C and D Complaint Closure Beneficiary Survey (8-6-12) CR_OY_SurveyInstrument_revisedclean.doc No No Paper Only

Health Health Care Services

 

5,300 0
   
Individuals or Households
 
   90 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 5,300 0 0 0 0 5,300
Annual IC Time Burden (Hours) 884 0 0 0 0 884
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
CR_OMB Advance Letter 100520 CR_OMB Advance Letter 100520.pdf 06/10/2010
CR_OMB Explanations for Inclusion of Survey Qs 100520 CR_OMB Explanations for Inclusion of Survey Qs 100520.pdf 06/10/2010
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.