View Information Collection (IC)

View Information Collection (IC)

GenIC #7 (Revision): Connecting Kids to Coverage Outreach and Enrollment CMCS
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-10398 #7 Semi-Annual Report Template ATTACHMENT 1-Semi-Annual Report Template508.pdf Yes Yes Fillable Fileable
Form CMS-10398 #7 Final Report Template ATTACHMENT 2-Final Report Template508.pdf Yes Yes Fillable Fileable
Form CMS-10398 #7 HK2019 and HK2020 Monthly Progress Report Template ATTACHMENT 3-HK2019 and HK2020 Monthly Progress Report Template508.pdf Yes Yes Fillable Fileable
Form CMS-10398 #7 HK2019 Monthly Progress Report with Targets Template ATTACHMENT 4-Monthly Progress Report with Targets.pdf Yes Yes Fillable Fileable
Form CMS-10398 #7 HK2022 and HK2023 Monthly Progress Report Template ATTACHMENT 5-HK2022 and HK2023 Monthly Progress Report Template.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

91 0
   
State, Local, and Tribal Governments
 
   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 1,365 0 1,365 0 0 0
Annual IC Time Burden (Hours) 7,826 0 7,826 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Generic Supporting Statement GenIC_7-Generic SupportingStatement_(2022 version 14).docx 12/13/2022
Track Change - HK2022 and HK2023 Monthly Progress Report Template Track Change - Attachment 5 - HK2022 and HK2023 Monthly Progress Report Template.pdf 12/13/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.