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

View Information Collection (IC)

LAN Documents (CMS-10670, CMS-10671, and CMS-10672)
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10670 LAN Summit Registration Form CMS-10670 GenIC 20 2018 LAN Summit Registration Form.jpg Yes Yes Fillable Fileable
Form and Instruction CMS-10671 LAN Summit Evaluation Form CMS-10671 GenIC21 2018 LAN Summit Evaluation Form.docx Yes Yes Fillable Fileable
Form and Instruction CMS-10672 LAN Session Evaluation Form CMS-10672 GenIC 22 2018 LAN Session Evaluation Form.docx Yes Yes Fillable Fileable

Health Health Care Services

 

3,360 672
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 3,360 0 3,360 0 0 0
Annual IC Time Burden (Hours) 414 0 414 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
LAN Burden Table 0938-1297 Burden Table for GenICs 20..21..22.docx 05/21/2018
CMS-10670 Supporting Statement CMS-10670 GenIC20 2018 LAN Summit Registration Form Supporting Statement.docx 05/21/2018
CMS-10671 Supporting Statement CMS-10671 GenIC21 2018 LAN Summit Evaluation Form Supporting Statememt.docx 05/21/2018
CMS-10672 Supporting Statement CMS-10672 GenIC18 2018 LAN Session Evaluation Form Supporting Statement.docx 05/21/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.