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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0255 Questionnarier for Annual Updates Telephone NPIN Questionnaire for Annual Updates (Telephone)	Form
0920-0255 Questionnarier for Annual Updates Telephone Att 3B_NPIN Questionnaire for Annual Updates.docx	Form

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	0920-0255				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 %

table that charts list of burden
	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

table that charts IC Documents
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.

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