Information Collection

[ORR] Post visit survey for facility evaluation of US National Authority for Containment of Poliovirus (NAC) Performance and Improvement

IC 279595 under ICR 202506-0920-002 · OMB 0920-1050.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1050 NAC Post-Site Visit Survey [ORR] Post visit survey for facility evaluation of US National Authority for Containment of Poliovirus (NAC) Performance and Improvement	Form and Instruction
0920-1050 NAC Post-Site Visit Survey Att1-NAC_Post-site Visit Survey_2026.docx	Form and Instruction
0920-1050-Request-GenIC NAC Post-site Survey2026.docx 0920-1050 GenIC Request Template	IC Document

IC Title:

Agency IC Tracking Number:

0920-26-0152

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 and Instruction	0920-1050			N/A	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	7	7
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
0920-1050 GenIC Request Template		03/24/2026

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

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