Information Collection Request

Generic Clearance for CMS and Medicare Administrative Contractor (MAC)Generic Customer Experience (CMS-10731)

ICR 202304-0938-022 · OMB 0938-1459 · Received in OIRA

Forms and Documents

Document Name	Status
Form CMS-10731. (GenIC# CMS-10731(GenIC#1). Was This Page Helpful Survey Form and Instruction	New
Form CMS-10731. (GenIC# CMS-10731.(GenIC#2) - CBR Feedback Survey Form and Instruction	New
CMS-10731_Supporting_Statement_Part_A (30-day).docx Supporting Statement A	2023-04-27

IC Document Collections

IC ID	Document Title	Status
272113	CMS-10731(GenIC#1). Was This Page Helpful Survey Form and Instruction	New
272112	CMS-10731.(GenIC#2) - CBR Feedback Survey Form and Instruction	New

ICR Details

Status	Received in OIRA
Agency/Subagency	HHS/CMS
OMB Control No	0938-1459
Type of Information Collection	New collection (Request for a new OMB Control Number)
Agency Tracking No	CM
Date Submitted to OIRA	1969-12-31
Requested Expiration Date	1969-12-31