Information Collection

Annual Census Of Patient Characteristics--1979 State And County Mental Hospital Inpatient Services

IC 111780 under ICR 198108-0930-003 · OMB 0930-0001.

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IC Title:

ANNUAL CENSUS OF PATIENT CHARACTERISTICS--1979 STATE AND COUNTY MENTAL HOSPITAL INPATIENT SERVICES

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

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	ADM 45-1				No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 103

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	103	103
Annual IC Time Burden (Hours)	206	206
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

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