Information Collection

[OPHDST] NBS 7 Transition User Assessment

IC 277032 under ICR 202506-0920-002 · OMB 0920-1050.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-25-0120 NBS 7 User Assesment [OPHDST] NBS 7 Transition User Assessment	Form
0920-25-0120 NBS 7 User Assesment NBS 7 Transition User Assessment Att A.docx	Form
0920-1050 NBS 7 Transition User Assessment_New Requirements.docx New Requirements	IC Document
0920-1050 NBS 7 Transition User Assessment_Approval Request.docx GenIC Request	IC Document

IC Title:

Agency IC Tracking Number:

0920-25-0120

IC Status: New

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	0920-25-0120				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 72

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	72	72
Annual IC Time Burden (Hours)	54	54
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
New Requirements		08/13/2025
GenIC Request		08/13/2025

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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