Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Annual Report Modified 18 540 0 Form and Instruction CMS-10371 Annual Report Template
Form and Instruction CMS-10371 Annual Reporting Data Elements
Application Removed 0 0 0 Form and Instruction CMS-10371 Revised FOA
Budget Report New 408 4080 0 Form and Instruction CMS-10371 Budget Report
Implementation Review Modified 36 4014 0 Form and Instruction CMS-10371 Exchange Establishment Grant FOA
Monthly Reports Modified 108 3769 0 Form and Instruction CMS-10371 Monthly Progress Report
Form and Instruction CMS-10371 Monthly Progress Report Data Elements
Performance Reviews Removed 0 0 0 Form and Instruction CMS-10371 Revised FOA
Form and Instruction CMS-10371 Revised FOA
Periodic Reporting Removed 0 0 0 Form and Instruction CMS-10371 Revised FOA
Public - Progress Reports Modified 68 680 0 Form and Instruction CMS-10371 Progress Report
Form and Instruction CMs-10371 Progress Report
Quarterly Reports Modified 72 3089 0 Form and Instruction CMS-10371 Quarterly Template
Semi-Annual Reports Modified 68 6120 0 Form and Instruction CMS-10371 Establishment Review - Semi-Annual
Start-Up Year Establishment Review Removed 0 0 0 Other-Data Elements
Weekly Reports Modified 234 8167 0 Form and Instruction CMS-10371 Weekly Report
Work Plan Update Modified 68 272 0 Form and Instruction CMS-10371 Establishment Review - Work Plan Update
Total burden requested under this ICR: 1080 30731 0  
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