Information Collection

Recognized Accrediting Entities Data Collection

IC 203909 under ICR 201308-0938-002 · OMB 0938-1176.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10449 Appendix C Recognized Accrediting Entities Data Collection	Form
Instructions for AE Submission-v2 REVISED 209-13-12.docx	Instruction
CMS-10449 Appendix C CMS-10449 Appendix C- AE - 508.pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 156.275

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
Instruction					Yes	Yes	Printable Only
Form	CMS-10449				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	60	30	30
Annual IC Time Burden (Hours)	3,544	1,772	1,772
Annual IC Cost Burden (Dollars)	194,940	194,940	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.

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