Chat/CCSQ Support Central – Basic information questions (CMS-10832)

Generic Clearance for the Center for Clinical Standards and Quality IT Product and Support Teams (CMS-10706)

Documents and Forms

Document Name Document Type
Form CMS-10832 Chat/CCSQ Support Central – Basic information questions (CMS-10832) Form and Instruction
CMS-10832 Support Central screen shots CMS-10832 Support Central Screen shot.docx Form and Instruction
CMS-10832 Support Central screen shots CMS-10832 Support Central Screen shot.docx Form and Instruction
CMS-10832 Data Collection ICR 6.29.22.docx Supporting Statement IC Document
CMS-10832 Data Collection ICR 6.29.22.docx Supporting Statement IC Document

Information Collection (IC) Details

IC Title:	Chat/CCSQ Support Central – Basic information questions (CMS-10832)	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

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-10832	Support Central screen shots	CMS-10832 Support Central Screen shot.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10,155	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	10,155	10,155
Annual IC Time Burden (Hours)	508	508
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement	CMS-10832 Data Collection ICR 6.29.22.docx	05/09/2024

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.