OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Issuer - Attest (Small Group)

IC 199284 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 - Attest (Small Group)
 
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 CMS-10320 - Issuer - FINAL Instructions and Instruments CMS-10320 Issuer - FINAL Instructions and Instruments.pdf Yes Yes Fillable Fileable
Instruction CMS 10320 Appendix C Issuer and Product Level Data_PRA 2020.pdf Yes Yes Paper Only
Instruction CMS 10320 Appendix D_Data Collection_PRA2020.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

150 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 150 0 0 -350 500 0
Annual IC Time Burden (Hours) 75 0 0 -175 250 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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