Drug Addiction and Alcoholism Referral and Monitoring Agency Treatment Requirements Acknowledgement, Drug Addiction and Alcoholism Referral Monitoring Agency Assessment/Referral and...

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IC Title:	Drug Addiction and Alcoholism Referral and Monitoring Agency Treatment Requirements Acknowledgement, Drug Addiction and Alcoholism Referral Monitoring Agency Assessment/Referral and...	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-386				No	No
Form	SSA-387				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 184,000	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,465,600	2,465,600
Annual IC Time Burden (Hours)	395,600	395,600
Annual IC Cost Burden (Dollars)	0	0

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