Information Collection Request
ICR 201506-0938-011 · OMB 0938-0568 · Public filing
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-0568 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form CMS-P-0015A Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A) |
Form and Instruction | Modified | Available |
 Attachment D - R73 USQ PPIC PAQ.pdf |
Supplementary Document | Uploaded 2015-06-24 | Available |
| Attachment C - R73 IAQ.pdf |
Supplementary Document | Uploaded 2015-06-24 | Available |
| Attachment B - R73 HFQ.pdf |
Supplementary Document | Uploaded 2015-06-24 | Available |
| Attachment A - R73 DUQ.pdf |
Supplementary Document | Uploaded 2015-06-24 | Available |
 MCBS Nonsubstantive change request.doc |
Justification for No Material/Nonsubstantive Change | Uploaded 2015-06-24 | Repair queued |
| MCBS Supporting Statement - Part B.pdf |
Supporting Statement B | Uploaded 2013-10-25 | Available |
| attachment10.pdf |
Supplementary Document | Uploaded 2013-10-25 | Available |
| attachment09.pdf |
Supplementary Document | Uploaded 2013-10-25 | Available |
| attachment07.pdf |
Supplementary Document | Uploaded 2013-10-25 | Available |
 Attachment 3.zip |
Supplementary Document | Uploaded 2013-10-25 | Repair queued |
| attachment 2.zip |
Supplementary Document | Uploaded 2013-10-25 | Repair queued |
| Attachments TOC.pdf |
Supplementary Document | Uploaded 2013-10-25 | Available |
 CMS-P-0015A Final Supporting Statement - Part A.docx |
Supporting Statement A | Uploaded 2013-10-29 | Available |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 8171 |  Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A) |
Form and Instruction | Modified |
ICR Details
| OMB Control No | 0938-0568 |
|---|