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GenIC #23 Marketplace OE survey
Generic Social Marketing & Consumer Testing Research (CMS-10437)
OMB: 0938-1247
IC ID: 269719
OMB.report
HHS/CMS
OMB 0938-1247
ICR 202407-0938-019
IC 269719
( )
Documents and Forms
Document Name
Document Type
Form CMS-10437.GenIC#23
GenIC #23 Marketplace OE survey
Form and Instruction
CMS-10437.GenIC#23 CMS-10437.GenIC#23 - MarketplaceOESurveyInstrument
CMS-10437.GenIC#23 - MarketplaceOESurveyInstrument.docx
Form and Instruction
CMS-10437.GenIC#23 CMS-10437.GenIC#23 - MarketplaceOESurveyInstrument
CMS-10437.GenIC#23 - MarketplaceOESurveyInstrument.docx
Form and Instruction
CMS-10437.GenIC#23 - Study Initiation Request Form.docx
CMS-10437.GenIC#23 - Study Initiation Request Form
IC Document
CMS-10437.GenIC#23 - Study Initiation Request Form.docx
CMS-10437.GenIC#23 - Study Initiation Request Form
IC Document
CMS-10437.GenIC#23 - MarketplaceOESurveySupportingStatement.docx
CMS-10437.GenIC#23 - MarketplaceOESurveySupportingStatement
IC Document
CMS-10437.GenIC#23 - MarketplaceOESurveySupportingStatement.docx
CMS-10437.GenIC#23 - MarketplaceOESurveySupportingStatement
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
GenIC #23 Marketplace OE survey
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-10437.GenIC#23
CMS-10437.GenIC#23 - MarketplaceOESurveyInstrument
CMS-10437.GenIC#23 - MarketplaceOESurveyInstrument.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
4,800
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
4,800
0
4,800
0
0
0
Annual IC Time Burden (Hours)
1,200
0
1,200
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
CMS-10437.GenIC#23 - Study Initiation Request Form
CMS-10437.GenIC#23 - Study Initiation Request Form.docx
08/06/2024
CMS-10437.GenIC#23 - MarketplaceOESurveySupportingStatement
CMS-10437.GenIC#23 - MarketplaceOESurveySupportingStatement.docx
08/06/2024
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.