Information Collection

Outcomes Data Collection of the National Prevention Information Network (Telephone) Survey Federal Government Organization

IC 182794 under ICR 200711-0920-009 · OMB 0920-0768.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0768 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix H NIPN Product & Services User Servey Telephone Script.doc	Instruction

IC Title:

Outcomes Data Collection of the National Prevention Information Network (Telephone) Survey Federal Government Organization

Agency IC Tracking Number:

Is this a Common Form? Yes

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 42 CFR 241

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
Instruction					Yes	No	Printable Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 11

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	22	22
Annual IC Time Burden (Hours)	6	6
Annual IC Cost Burden (Dollars)	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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