Information Collection

NPIN Online Questionnaire for New Organizations

IC 223253 under ICR 202406-0920-003 · 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⚠️ Notice: This information collection may be referencing outdated material.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
NPIN Online Questionnaire for New Organizations	Form and Instruction
NPIN Online Questionnaire Att 4_NPIN Online Questionnaire_with Mpox Vaccine and Mpox Testing.docx	Form and Instruction
NPIN Online Questionnaire Att 4_NPIN Online Questionnaire_with Mpox Vaccine and Mpox Testing.docx	Form and Instruction
0920-0255 NPIN Online Questionnaire-Doxy PEP_Free mpox vaccine Att 4‑ScreenShots_NPIN Online Questionnaire_Free mpox vaccine and Doxy PEP.docx	Form and Instruction
0920-0255 NPIN Online Questionnaire-Doxy PEP_Free mpox vaccine Att 4‑ScreenShots_NPIN Online Questionnaire_Free mpox vaccine and Doxy PEP.docx	Form and Instruction

IC Title:

NPIN Online Questionnaire for New Organizations

Agency IC Tracking Number:

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 and Instruction	None	NPIN Online Questionnaire	Att 4_NPIN Online Questionnaire_with Mpox Vaccine and Mpox Testing.docx		Yes	Yes	Fillable Fileable
Form and Instruction	0920-0255	NPIN Online Questionnaire-Doxy PEP_Free mpox vaccine	Att 4âScreenShots_NPIN Online Questionnaire_Free mpox vaccine and Doxy PEP.docx	N/A	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,605

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 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	1,605	1,605
Annual IC Time Burden (Hours)	161	161
Annual IC Cost Burden (Dollars)	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.