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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.