NPCR - Program Evaluation Instrument (NPCR-PEI)

National Program of Cancer Registries Program Evaluation Instrument

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0706 can be found here:

Documents and Forms

Document Name Document Type
NPCR - Program Evaluation Instrument (NPCR-PEI) Form
NPCR Program Evaluation Att 3A_0706_PEI Instrument Screenshots_2013.docx Form
Att 3B_0706_Sample Letter w Inst_2012.docx Att 3b - Sample Letter IC Document
Att 3C_Summary of Proposed Changes.docx Att 3c - Summary of Changes IC Document

Information Collection (IC) Details

IC Title:	NPCR - Program Evaluation Instrument (NPCR-PEI)	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	NPCR Program Evaluation	Att 3A_0706_PEI Instrument Screenshots_2013.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 32	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	32	32
Annual IC Time Burden (Hours)	64	64
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Att 3b - Sample Letter	Att 3B_0706_Sample Letter w Inst_2012.docx	04/18/2013
Att 3c - Summary of Changes	Att 3C_Summary of Proposed Changes.docx	04/18/2013

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