OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Marketplace Survey Data Collection

IC 210331 under ICR 201409-0938-006 · OMB 0938-1221.

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)

Marketplace Survey Data Collection
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10488 Marketplace Survey - Chinese CMS-10488 - Marketplace Survey_Chinese.pdf Yes Yes Fillable Fileable
Form and Instruction CMS-10488 Marketplace Survey Spanish CMS-10488 - Marketplace Survey_Spanish.pdf Yes Yes Fillable Fileable
Form and Instruction CMS-10488 Marketplace Survey English CMS-10488 - Marketplace Survey English.docx Yes Yes Fillable Fileable

Health Health Care Services

 

64,350 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  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 64,350 0 0 0 0 64,350
Annual IC Time Burden (Hours) 25,740 0 0 0 0 25,740
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.