View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Mode Experiment
 
No Removed
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-10500 No   Fillable Fileable
Form and Instruction CMS-10500 Yes Yes Fillable Fileable
Form and Instruction CMS-10500 Yes Yes Fillable Fileable

Health Health Care Services

 

7,850 0
   
Individuals or Households
 
   0 %

  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 0 0 -7,850 0 0 7,850
Annual IC Time Burden (Hours) 0 0 -1,021 0 0 1,021
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Cover Letters (Mail Mode) 07/31/2018
Letter Invitation (Web Survey) First Contact 07/31/2018
E-mail Invitation (Web Survey) First Contact 07/31/2018
E-mail Invitation (Web Survey) Reminder 07/31/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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