Information Collection

Att 6c_MPINC Facility Survey

IC 179025 under ICR 201808-0920-010 · OMB 0920-0743.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0743 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att. 6c mPINC Facility Survey.doc	Other-WORD
0920-0743 CDC mPINC Hospital Suvey (Maternity Practices in Infant Att. 3m Screenshots mPINC Survey.docx	Form and Instruction
Att. 6a Survey Cover Letter paper.docx Att 6a_Survey Cover Letter	IC Document
Att. 6b Survey Cover Letter email.docx Att 6b_Survey Cover Letter (E-mail)	IC Document
Att. 6d Reminder (paper).docx Att 6d_Reminder	IC Document
Att. 6e Reminder (e-mail).docx Att 6e_Reminder (e-mail)	IC Document
Att. 6f Non-Responder Follow-Up.docx Att 6f_Non-Responder Follow-Up	IC Document
Att. 6g Non-Responder Script.docx Att 6g_Non-Responder Script	IC Document
Att. 6h Returned Surveys paper.docx Att 6h_Returned Surveys	IC Document
Att. 6i Returned Surveys e-mail.docx Att 6i_Returned Surveys (E-mail)	IC Document

IC Title:

Att 6c_MPINC Facility Survey

Agency IC Tracking Number:

0920-0743

Is this a Common Form? No

IC Status: Modified

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
Other-WORD			Att. 6c mPINC Facility Survey.doc		No		Paper Only
Form and Instruction	0920-0743	CDC mPINC Hospital Suvey (Maternity Practices in Infant Nutrition and Care 2018)	Att. 3m Screenshots mPINC Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,421

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,421	1,421
Annual IC Time Burden (Hours)	711	711
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Att 6a_Survey Cover Letter	Att. 6a Survey Cover Letter paper.docx	08/14/2018
Att 6b_Survey Cover Letter (E-mail)	Att. 6b Survey Cover Letter email.docx	08/14/2018
Att 6d_Reminder	Att. 6d Reminder (paper).docx	08/14/2018
Att 6e_Reminder (e-mail)	Att. 6e Reminder (e-mail).docx	08/14/2018
Att 6f_Non-Responder Follow-Up	Att. 6f Non-Responder Follow-Up.docx	08/14/2018
Att 6g_Non-Responder Script	Att. 6g Non-Responder Script.docx	08/14/2018
Att 6h_Returned Surveys	Att. 6h Returned Surveys paper.docx	08/14/2018
Att 6i_Returned Surveys (E-mail)	Att. 6i Returned Surveys e-mail.docx	08/14/2018

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