Information Collection

NCHHSTP] NPIN Initial Questionnaire Telephone Script for New Organizations

IC 223251 under ICR 202307-0920-004 · 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⚠️ Notice: This information collection may be referencing outdated material.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 NCHHSTP] NPIN Initial Questionnaire Telephone Script for New Organizations Form and Instruction
Form 0920-0255 NCHHSTP] NPIN Initial Questionnaire Telephone Script for New Organizations Form and Instruction
0920-0255 NPIN Initial Questionnaire Telephone Script Att 3A_NPIN Initial Questionnaire Phone Script _OMB0920-0255.docx Form and Instruction
0920-0255 NPIN Initial Questionnaire Telephone Script Att 3A_NPIN Initial Questionnaire Phone Script _OMB0920-0255.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NCHHSTP] NPIN Initial Questionnaire Telephone Script for New Organizations	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 and Instruction	0920-0255	NPIN Initial Questionnaire Telephone Script	Att 3A_NPIN Initial Questionnaire Phone Script _OMB0920-0255.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,200	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: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,200	400	800
Annual IC Time Burden (Hours)	140	47	93
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.