Information Collection

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

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

Documents and Forms

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

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NPCR - Program Evaluation Instrument (NPCR-PEI) (Paper)	Agency IC Tracking Number:	0920-0706

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	0920-0706	PEI (Paper)	0920-0706 Attachment 1_NPCR PEI Survey 2026 -Paper Version_V2.docx		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 %

	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

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

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