Information Collection

[ORR] Poliovirus Facility Response Readiness Survey

IC 279613 under ICR 202512-0920-009 · OMB 0920-1154.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Poliovirus Response Readiness Survey [ORR] Poliovirus Facility Response Readiness Survey	Form and Instruction
Poliovirus Response Readiness Survey Att4-PVDF Readiness Survey_2026v1.docx	Form and Instruction
Att 3 0920-1154-NAC Survey Tool - GenICRequestTemplate.docx GenIC Request Template	IC Document
Att 5 - Non-research determination.pdf Research Determination	IC Document
0920-1154-SSA - NAC Survey Tool_final.docx SSA	IC Document
0920-1154-SSB - NAC Survey Tool_final.docx SSB	IC Document

IC Title:

Agency IC Tracking Number:

0920-26-0153

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	n/a				Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

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	100	100
Annual IC Time Burden (Hours)	75	75
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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

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