Form CMS-10333 Appendix 1

Consumer Assistance Program Grants

CMS-10333 Appendix 1_Screenshots of CCIIO-Developed Database

Data Collection Report (Initial Submission)

OMB: 0938-1097

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Appendix 1
Screenshots of CCIIO-Developed Database

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been
publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated,
distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to
the full extent of the law.

6/26/2012

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been
publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated,
distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to
the full extent of the law.

6/26/2012

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been
publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated,
distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to
the full extent of the law.

6/26/2012

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been
publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated,
distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to
the full extent of the law.

6/26/2012

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been
publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated,
distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to
the full extent of the law.

6/26/2012

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been
publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated,
distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to
the full extent of the law.

6/26/2012

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been
publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated,
distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to
the full extent of the law.

6/26/2012

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been
publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated,
distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to
the full extent of the law.

6/26/2012

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been
publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated,
distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to
the full extent of the law.

6/26/2012


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AuthorAnna McCourt
File Modified2012-07-18
File Created2012-07-18

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