Information Collection

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

IC 115734 under ICR 199501-0960-001 · OMB 0960-0548.

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Information Collection (IC) Details

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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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-387				No	No
Form	SSA-386				No	No

Federal Enterprise Architecture Business Reference Module

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 %

table that charts list of burden
	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

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

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