OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Initial and Terminal Administration of the Survey

IC 199899 under ICR 201408-0938-002 · OMB 0938-1167.

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

View Information Collection (IC)

Initial and Terminal Administration of the Survey
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10403 CCTP -Spanish Version Appendix B CCTP items in Spanish.docx No No Paper Only
Form and Instruction CMS-10403 CCTP 1st Admin Participant Exp Suvey Revised CCTP 1st Admin Participant Exp Survey Revised 07_15_2014.docx No   Paper Only
Form and Instruction CMs-10403 CCTP 2nd Admin Participant Exp Survey Revised CCTP 2nd Admin Participant Exp Survey_Revised 07.15.2014.docx No   Paper Only

Health Health Care Services

 

216,000 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  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 432,000 0 0 0 0 432,000
Annual IC Time Burden (Hours) 54,000 0 0 0 0 54,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.