Information Collection

Outcomes Data Collection of the National Prevention Information Network NPIN Products and Services User Survey

IC 182788 under ICR 201102-0920-012 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Outcomes Data Collection of the National Prevention Information Network NPIN Products and Services User Survey	Form
NPIN Products and Services User Survey 0920_0768_2010_NPIN_att3-D_ProdServiceSurvey.doc	Form
0920_0768_2010_NPIN_att3-C_IntroForProdServiceSurvey.doc Product and Services User Survey intro	IC Document
0920_0768_2010_NPIN_att3-E_ReminderForProdServiceSurvey.doc Product and Services User Survey reminder	IC Document

IC Title:

Outcomes Data Collection of the National Prevention Information Network NPIN Products and Services User Survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

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	none	NPIN Products and Services User Survey	0920_0768_2010_NPIN_att3-D_ProdServiceSurvey.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,000	-3,310	4,310
Annual IC Time Burden (Hours)	217	-861	1,078
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Product and Services User Survey intro	0920_0768_2010_NPIN_att3-C_IntroForProdServiceSurvey.doc	01/27/2011
Product and Services User Survey reminder	0920_0768_2010_NPIN_att3-E_ReminderForProdServiceSurvey.doc	01/27/2011

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.