PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Development of Agreement
Unchanged
125
125
0
Form
CMS-10326
SAMPLE Affiliation Agreement
Electronic Submission to CMS
Unchanged
125
10
0
Form
CMS-10326
SAMPLE Affiliation Agreement
Hardcopy Submission to FI or MAC
Unchanged
125
31
0
Form
CMS-10326
SAMPLE Affiliation Agreement
Total burden requested under this ICR:
375
166
0
To view an IC, click on IC Title
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