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155.225(d)(1) - Training certificate retention

IC 208217 under ICR 202210-0938-013 · OMB 0938-1205.

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Form and Instruction
Form and Instruction
Form and Instruction
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155.225(d)(1) - Training certificate retention
 
No Unchanged
 
Required to Obtain or Retain Benefits
 
45 CFR 155.225(d)(1)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10494 Registration CMS-10494-F2-APPENDIX A.docx Yes Yes Fillable Fileable

Health Health Care Services

 

5,000 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   80 %

  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 30,000 0 0 0 0 30,000
Annual IC Time Burden (Hours) 480 0 0 0 0 480
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Data Elements CMS-2334-F2-APPENDIX B.docx 03/08/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.