Information Collection

NPCR - Program Evaluation Instrument (NPCR-PEI) (Paper)

IC 229225 under ICR 202506-0920-012 · OMB 0920-0706.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0706 NPCR - Program Evaluation Instrument (NPCR-PEI) (Paper)	Form
Form 0920-0706 PEI (Paper) NPCR - Program Evaluation Instrument (NPCR-PEI) (Paper)	Form
0920-0706 PEI (Paper) 0920-0706 Attachment 1_NPCR PEI Survey 2026 -Paper Version_V2.docx	Form
0920-0706 PEI (Paper) 0920-0706 Attachment 1_NPCR PEI Survey 2026 -Paper Version_V2.docx	Form

IC Title:

Agency IC Tracking Number:

0920-0706

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	0920-0706				No		Paper Only

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	3	3
Annual IC Time Burden (Hours)	12	12
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.

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