OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

AM (Data Collection and Submission)

IC 230225 under ICR 202511-0938-012 · OMB 0938-1237.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form CMS-10495
Open Payments User Guide AM (Data Collection and Submission)		 Form and Instruction
Form CMS-10495
General-Research-Ownership Submission Data Elements and Screen Shots AM (Data Collection and Submission)		 Form and Instruction
CMS-10495 Open Payments User Guide
Open Payments User Guide_for_Reporting_Entities - 508 Compliant cf 1-31.pdf 		Form and Instruction
CMS-10495 General-Research-Ownership Submission Data Elements and
General-Research-Ownership Submission Data Elements 9.23.2020 - 508 new.pdf 		Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

layout table

Information Collection Instruments:
table that charts list of instruments
Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10495 Yes Yes Paper Only
Form and Instruction CMS-10495 Yes Yes Fillable Fileable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  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 2,473 0 0 0 0 2,473
Annual IC Time Burden (Hours) 1,726,662 0 0 0 0 1,726,662
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
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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