Data Management Plan Self-Attestation Questionnaire (DMP SAQ)

Data Use Agreement (DUA) Form, Research Identifiable Files Request Packet Packet, and Data Management Plan (CMS-R-235)

OMB: 0938-0734

IC ID: 253071

Information Collection (IC) Details

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Data Management Plan Self-Attestation Questionnaire (DMP SAQ)
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-R-235 Data Management Plans Self Attestation Questionnaire (DMP SAQ) CMS DPSP DMP SAQ 3.1_OMB_approved_secondaryPOC.pdf Yes Yes Fillable Printable

Health Health Care Services

 

1,000 0
   
Private Sector Not-for-profit institutions
 
   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 1,000 0 1,000 0 0 0
Annual IC Time Burden (Hours) 1,500 0 1,500 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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