Information Collection

Outcomes Data Collection of the National Prevention Information Network NPIN Website User Survey

IC 182787 under ICR 201103-0920-005 · OMB 0920-0768.

Documents and Forms

Document Name Document Type
Outcomes Data Collection of the National Prevention Information Network NPIN Website User Survey Form
NPIN Website User Survey 0920_0768_2010_NPIN_att3-B_WebSiteSurvey.doc Form
0920_0768_2010_NPIN_att3-A_IntroForWebSiteSurvey.doc Attachment 3a - Intro to Website survey IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Outcomes Data Collection of the National Prevention Information Network NPIN Website User Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 42 CFR 241

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	NPIN Website User Survey	0920_0768_2010_NPIN_att3-B_WebSiteSurvey.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

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

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	500	0	-578	1,078
Annual IC Time Burden (Hours)	125	-110	0	235
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment 3a - Intro to Website survey	0920_0768_2010_NPIN_att3-A_IntroForWebSiteSurvey.doc	03/14/2011

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