Information Collection

TVT Registry

IC 204893 under ICR 201211-0938-005 · OMB 0938-1202.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1202 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10443 TVT Registry	Form and Instruction
CMS-10443 TVT Data Collection Form TVT_v1_1_DataCollectionForm_Final.sflb.pdf	Form and Instruction

IC Title:

TVT Registry

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10443	TVT Data Collection Form	TVT_v1_1_DataCollectionForm_Final.sflb.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	6,000	6,000
Annual IC Time Burden (Hours)	4,900	4,900
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.