Information Collection

NPIN Online Questionnaire for New Organizations

IC 223253 under ICR 202603-0920-007 · OMB 0920-0255.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
NPIN Online Questionnaire NPIN Online Questionnaire for New Organizations	Form and Instruction
Form 0920-0255 NPIN Online Questionnaire-Doxy PEP_Free mpox vaccine NPIN Online Questionnaire for New Organizations	Form and Instruction
Form 0920-0255 NPIN Online Questionnaire_MAR2026 NPIN Online Questionnaire for New Organizations	Form and Instruction
NPIN Online Questionnaire Att 4_NPIN Online Questionnaire_with Mpox Vaccine and Mpox Testing.docx	Form and Instruction
0920-0255 NPIN Online Questionnaire-Doxy PEP_Free mpox vaccine Att 4‑ScreenShots_NPIN Online Questionnaire_Free mpox vaccine and Doxy PEP.docx	Form and Instruction
0920-0255 NPIN Online Questionnaire_MAR2026 Att 4_ NPIN Online Questionnaire_clean.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

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.	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	None		Yes	Yes	Fillable Fileable
Form and Instruction	0920-0255	N/A	Yes	Yes	Fillable Fileable
Form and Instruction	0920-0255	N/A	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,965

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
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,965	360	1,605
Annual IC Time Burden (Hours)	197	36	161
Annual IC Cost Burden (Dollars)	0	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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