OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

MACBIS Software Application Electronic Surveys for Users - Webinar Survey Polling Questions (CMS-10719)

IC 257123 under ICR 202211-0938-011 · OMB 0938-1185.

Documents and Forms
Document Name
Document Type
Form
Form
Form
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

MACBIS Software Application Electronic Surveys for Users - Webinar Survey Polling Questions (CMS-10719)
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-10719 MACBIS Software Application Electronic Survey Webinar Survey_Polling Questions.xlsx Yes Yes Fillable Fileable

Health Health Care Services

 

2,775 0
   
State, Local, and Tribal Governments
 
   100 %

  Requested 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 2,081 0 2,081 0 0 0
Annual IC Time Burden (Hours) 173 0 173 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
CMS-10719 - Fast Track Supporting Statement - Nov 2020 udpate v2 CLEAN CMS-10719 - Fast Track Supporting Statement - Nov 2020 udpate v2 CLEAN.docx 11/25/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.