Information Collection

Participants in POC NAT Acceptability Survey

IC 247954 under ICR 202209-0920-005 · OMB 0920-1357.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1357 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Participants in POC NAT Acceptability Survey	Form and Instruction
NAT Acceptability Survey Att 12_POC NAT acceptability survey_screenshots_10-28-21.pdf	Form and Instruction
NAT Acceptability Survey Att 12_POC NAT acceptability survey_screenshots_10-28-21.pdf	Form and Instruction

IC Title:

Participants in POC NAT Acceptability Survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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 and Instruction	n/a	NAT Acceptability Survey	Att 12_POC NAT acceptability survey_screenshots_10-28-21.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 117

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	117	117
Annual IC Time Burden (Hours)	39	39
Annual IC Cost Burden (Dollars)	746	746

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.