Information Collection

National Sample Survey of Nurse Practitioners

IC 200434 under ICR 201112-0915-002 · OMB 0915-0348.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 NSSNP Questionnaire National Sample Survey of Nurse Practitioners	Form
1 NSSNP Questionnaire OMB NSSNP Questionnaire_FINAL_2.17.12.docx	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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	1				No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 14,300

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	14,300	14,300
Annual IC Time Burden (Hours)	4,719	4,719
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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