Information Collection

2020 mPINC survey

IC 239965 under ICR 202002-0920-008 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
Form 0920-20FN 2020 mPINC survey Form
0920-20FN 2020 mPINC survey mPINC Facility Survey_2020_final.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	2020 mPINC survey	Agency IC Tracking Number:	0920-20FN

Is this a Common Form? No		IC Status: New

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	0920-20FN	2020 mPINC survey	mPINC Facility Survey_2020_final.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,421	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	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

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.