Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Annual Report Unchanged 18 540 0 Form and Instruction CMS-10371 Annual Report Template
Form and Instruction CMS-10371 Annual Reporting Data Elements
Budget Report Modified 216 2160 0 Form and Instruction CMS-10371 Budget Report
Implementation Review Removed 0 0 0 Form and Instruction CMS-10371 Exchange Establishment Grant FOA
Monthly Reports Removed 0 0 0 Form and Instruction CMS-10371 Monthly Progress Report
Form and Instruction CMS-10371 Monthly Progress Report Data Elements
Public - Progress Reports Removed 0 0 0 Form and Instruction CMS-10371 Progress Report
Form and Instruction CMs-10371 Progress Report
Quarterly Reports Modified 72 1656 0 Form and Instruction CMS-10371 Quarterly Template
SBM Individual Market Reports (weekly and monthly) New 216 6350 0 Form and Instruction CMS-10371 SBM Individual Market Reporting
SBM Three-year Budget Reports New 17 272 0 Form and Instruction CMS-10371 SBM Three-Year Budget Template
Semi-Annual Reports Modified 15 1350 0 Form and Instruction CMS-10371 Establishment Review - Semi-Annual
Weekly Reports Removed 0 0 0 Form and Instruction CMS-10371 Weekly Report
Work Plan Update Removed 0 0 0 Form and Instruction CMS-10371 Establishment Review - Work Plan Update
Total burden requested under this ICR: 554 12328 0  
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