NSQAP Enrollment Form (Private)

NCEH DLS Laboratory Quality Assurance Programs

Documents and Forms

Document Name Document Type
NSQAP Enrollment Form (Private) Form
NSQAP Enrollment Form Att 3m. NSQAP Enrollment Form.jpg Form
NSQAP Enrollment Form Att 3m. NSQAP Enrollment Form.jpg Form

Information Collection (IC) Details

IC Title:	NSQAP Enrollment Form (Private)	Agency IC Tracking Number:	0920-22AW

Is this a Common Form? No		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	n/a	NSQAP Enrollment Form	Att 3m. NSQAP Enrollment Form.jpg		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 32	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 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	32	-536	568
Annual IC Time Burden (Hours)	5	-90	95
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.