Information Collection

NPIN Questionnaire for Annual Updates (Telephone)

IC 223252 under ICR 201911-0920-001 · OMB 0920-0255.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0255 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-0255 NPIN Questionnaire for Annual Updates (Telephone) Form
0920-0255 Questionnarier for Annual Updates Telephone Att 3B_NPIN Questionnaire for Annual Updates.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NPIN Questionnaire for Annual Updates (Telephone)	Agency IC Tracking Number:	0920-0255

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	0920-0255	Questionnarier for Annual Updates Telephone	Att 3B_NPIN Questionnaire for Annual Updates.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 6,100	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	6,100	0	6,100
Annual IC Time Burden (Hours)	610	-407	1,017
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.