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

Outcomes Data Collection of the National Prevention Information Network

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

Information Collection (IC) Details

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:

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 %

	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

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.