Information Collection

2017 NCORP Annual Meeting Assessment and Feedback

IC 227901 under ICR 201702-0925-001 · OMB 0925-0642.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0642 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 2017 NCORP Annual Meeting Assessment and Feedback	Form
1 SurveyMonkey for NCORP SurveyMonkey_120480718.pdf	Form
OMB Fast Track - NCORP Annual Meeting 8-14-2017.docx Fast track - NCORP Annual Meeting	IC Document

IC Title:

2017 NCORP Annual Meeting Assessment and Feedback

Agency IC Tracking Number:

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	SurveyMonkey for NCORP	SurveyMonkey_120480718.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 225

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	225	225
Annual IC Time Burden (Hours)	38	38
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast track - NCORP Annual Meeting	OMB Fast Track - NCORP Annual Meeting 8-14-2017.docx	08/15/2017

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