Form CMS-10494 Registration
Exchange Functions: Standards for Navigators and Non-Navigator Assistance Personnel - CAC (CMS-10494)
CMS-10494-F2-APPENDIX A
155.225(d)(1) - Training certificate proof
OMB: 0938-1205
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-1205 can be found here:
Document [docx]
Download: docx | pdf
Expiration Date: XX/XXXX
APPENDIX A - Registration Screen Shots
Image 1
Self-Assign User ID and Password Page Example
Registration Page Example
Curriculum Page Example
Transcript Page Example
Certificate Example
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | HMR |
| File Modified | 0000-00-00 |
| File Created | 2021-01-20 |
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