Information Collection Request

Supporting Statement for Agent/Broker Consent Information Collection (CMS-10840)

ICR 202602-0938-011 · OMB 0938-1438 · Received in OIRA

Forms and Documents

Document Name	Status

No forms / supporting documents in this ICR. Check IC Document Collections.

IC Document Collections

IC ID	Document Title	Status
279055	Burden to Respond to Misleading Marketing	New
259918	Agent/Broker Eligibility and Consent Records Form and Instruction	Modified
257714	Agent/Broker Eligibility and Consent Documentation Form	Modified

ICR Details

Status	Received in OIRA
Agency/Subagency	HHS/CMS
OMB Control No	0938-1438
Type of Information Collection	Revision of a currently approved collection
Previous ICR Reference No	202501-0938-002
Agency Tracking No	CCIIO
Date Submitted to OIRA	1969-12-31
Requested Expiration Date	1969-12-31