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Federal forms, ICRs, and supporting documents

Information Collection

Nursing Organization Questionnaire

IC 220388 under ICR 202102-0920-003 · OMB 0920-1129.

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Form
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Information Collection (IC) Details

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Nursing Organization Questionnaire 17ADN
 
No Removed
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form nopne Nursing Organization Questionnaire Brief Questionnaire for Nursing Organization Memberships (Online).pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

 

2,934 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 0 0 0 -2,934 2,934 0
Annual IC Time Burden (Hours) 0 0 0 -489 489 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Brief Questionnaire for Nursing Brief Questionnaire for Nursing Organization Memberships_Edited.docx 05/09/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.