New Freedom Initiative - Web-based Reporting System for Grantees

New Freedom Initiative - Web-based Reporting System for Grantees (CMS-10161)

Documents and Forms

Document Name Document Type
Form CMS-10161 New Freedom Initiative - Web-based Reporting System for Grantees Form and Instruction
CMS-10161 Real Choice Systems Change Grants Web-Based Reporting Sy 2005 Sys Change Annual for OMB.ppt Form and Instruction

Information Collection (IC) Details

IC Title:	New Freedom Initiative - Web-based Reporting System for Grantees	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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 and Instruction	CMS-10161	Real Choice Systems Change Grants Web-Based Reporting System FFY 2005 Annual Report	2005 Sys Change Annual for OMB.ppt		No	No	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 171	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	428	428
Annual IC Time Burden (Hours)	3,764	3,764
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.