CMS Computer-Based Training (CBT) Evaluation Form

Clearance for Evaluation of Stakeholder Training Health Insurance Marketplace and Market Stabilization Programs (CMS-10598)

Documents and Forms

Document Name Document Type
Form CMS-10598 CMS Computer-Based Training (CBT) Evaluation Form Form and Instruction
CMS-10598 CMS Computer-Based Training (CBT) Evaluation Form CMS-10598 - Stakeholder CBT Evaluation.docx Form and Instruction

Information Collection (IC) Details

IC Title:	CMS Computer-Based Training (CBT) Evaluation Form	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-10598	CMS Computer-Based Training (CBT) Evaluation Form	CMS-10598 - Stakeholder CBT Evaluation.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 19	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	19	19
Annual IC Time Burden (Hours)	5	5
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.