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IRS/SSA/CMS Data Match and Supporting Regulations in 42 CFR Sections 411.20-411.206
IRS/SSA/CMS Data Match and Supporting Regulations in 42 CFR Sections 411.20-411.206
OMB: 0938-0565
IC ID: 8156
OMB.report
HHS/CMS
OMB 0938-0565
ICR 200510-0938-013
IC 8156
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0565 can be found here:
2013-09-13 - Reinstatement without change of a previously approved collection
2009-01-30 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
IRS/SSA/CMS Data Match and Supporting Regulations in 42 CFR Sections 411.20-411.206
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Migrated
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
CMS-R-137
Yes
Yes
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
341,065
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
9 %
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
341,065
0
0
13,118
0
327,947
Annual IC Time Burden (Hours)
1,986,810
0
0
890,344
0
1,096,466
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.