Information Collection

POC NAT Acceptability Survey

IC 247954 under ICR 202411-0920-009 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Form 0920-1357 POC NAT Acceptability Survey	Form and Instruction
0920-1357 NAT Acceptability Survey (SCREENSHOTS) Att 12_POC NAT acceptability survey_screenshots_10-28-21.pdf	Form and Instruction
0920-1357 NAT Acceptability Survey (SCREENSHOTS) Att 12_POC NAT acceptability survey_screenshots_10-28-21.pdf	Form and Instruction

IC Title:

POC NAT Acceptability Survey

Agency IC Tracking Number:

0920-1357-24AQ

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	0920-1357	NAT Acceptability Survey (SCREENSHOTS)	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: 500

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	500	500
Annual IC Time Burden (Hours)	167	167
Annual IC Cost Burden (Dollars)	3,190	3,190

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.