OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Issuer - Data Entry (Individual)

IC 199279 under ICR 202510-0938-001 · OMB 0938-1086.

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

View Information Collection (IC)

Issuer - Data Entry (Individual)
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10320 Issuer Instructions and Instruments CMS-10320.Issuer - FINAL Instructions and Instruments (5-12-10).pdf Yes Yes Fillable Fileable
Instruction CMS-10320 - Appendix C Insurance Issuer and Product Level Data.pdf Yes Yes Paper Only
Instruction CMS 10320 Appendix D_Data Collection_PRA2020.pdf Yes Yes Paper Only

Health Health Care Services

 

350 0
   
Private Sector Businesses or other for-profits
 
   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 350 0 0 -150 500 0
Annual IC Time Burden (Hours) 1,400 0 0 -600 2,000 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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