OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

National Readiness Survey

IC 211401 under ICR 201404-0938-008 · OMB 0938-1252.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
IC Document
Information Collection (IC) Details

View Information Collection (IC)

National Readiness Survey
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10509 National Survey of Medicare Beneficiaries OMB_Wellness_Eval_Part_A_Attachment_2_National_Surveys_08122014_clean.docx No   Fillable Fileable

Health Health Care Services

 

18,000 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 18,000 0 18,000 0 0 0
Annual IC Time Burden (Hours) 8,529 0 8,529 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Legal Authority OMB_Draft_Wellness_Eval_Part_A_Attachment_1_Legal_Authority_03112014.pdf 04/28/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.