View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	[CPR] Post Visit Survey for Facility Evaluation of US National Authority for Containment of Poliovirus (NAC) Performance and Improvement	Agency IC Tracking Number:	0920-1050-24FV

IC Status: New

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 and Instruction	n/a	Post Site Visit Survey	Att1-NAC Post-site Survey.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

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: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	40	0	40	0	0	0
Annual IC Time Burden (Hours)	7	0	7	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
GenIC Request Template	0920-1050-Request-GenIC NAC Post-site Survey.docx	05/23/2024

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