Information Collection

Nursing Organization Questionnaire

IC 220388 under ICR 201603-0920-002 · OMB 0920-1129.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1129 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form nopne Nursing Organization Questionnaire Nursing Organization Questionnaire	Form
nopne Nursing Organization Questionnaire Q5 Brief Questionnaire for Nursing Organization Memberships.pdf	Form
G6 Brief Questionnaire for Nursing Organization Memberships.docx Nursing Organization Questionnaire	IC Document

IC Title:

Nursing Organization Questionnaire

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	nopne	Nursing Organization Questionnaire	Q5 Brief Questionnaire for Nursing Organization Memberships.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,934

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,934	2,934
Annual IC Time Burden (Hours)	489	489
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Nursing Organization Questionnaire	G6 Brief Questionnaire for Nursing Organization Memberships.docx	03/02/2016

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