ORS Quarterly Reporting Template

[NCIPC] Overdose Response Strategy Data Collection

Documents and Forms

Document Name Document Type
Form 0920-25AC ORS Quarterly Reporting Template Form
0920-25AC ORS Quarterly Reporting Template Att I_ORS Quarterly Reporting Template.docx Form
0920-1461 ORS Quarterly Reporting Template 07JAN2026 Att I_ORS Quarterly Reporting Template change request_clean.docx Form and Instruction

Information Collection (IC) Details

IC Title:	ORS Quarterly Reporting Template	Agency IC Tracking Number:	0920-25AC

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	0920-25AC				Yes	Yes	Fillable Fileable
Form and Instruction	0920-1461			N/A	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 61	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	488	488
Annual IC Time Burden (Hours)	488	488
Annual IC Cost Burden (Dollars)	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.

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