Form CMS-10494 Training Certificate
Exchange Functions: Standards for Navigators and Non-Navigator Assistance Personnel - CAC (CMS-10494)
CMS-10494 - Appendix E_ SampleTraining Completion Certificate (1)
155.225(b)(1)(i) (certificate issuance)
OMB: 0938-1205
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-1205 can be found here:
Document [docx]
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Expiration Date: XX/XXXX
MLMS Assister Training Certificate Mock-Up
Graphic 1- Example Certificate for Assisters
Written description of Mock-up Certification example for the MLMS Assister Training.
Certificate says:
Certificate of Completion
This is to certify that
John Smith
Has successfully completed the following:
Marketplace Assister Training
On
02/17/2015
Authorized Signature
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Shannon Holdenried |
| File Modified | 0000-00-00 |
| File Created | 2021-11-04 |
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