Information Collection

TVT Registry

IC 204893 under ICR 202011-0938-010 · OMB 0938-1202.

Documents and Forms

Document Name Document Type
Form CMS-10443 TVT Registry Form and Instruction
CMS-10443 TVT Registry 2-1_tvt_tavrdcf 2020.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	TVT Registry	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10443	TVT Registry	2-1_tvt_tavrdcf 2020.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 37,221	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	37,221	22,350	14,871
Annual IC Time Burden (Hours)	34,738	20,908	13,830
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.