Information Collection

Obligated Service for Mental Health Traineeships: Regulations and Forms

IC 7489 under ICR 200101-0930-002 · OMB 0930-0074.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0074 can be found here:

Documents and Forms

Document Name Document Type

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Information Collection (IC) Details

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IC Title:	Obligated Service for Mental Health Traineeships: Regulations and Forms	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	SMA-111-1	No	No
Form	SMA-111	No	No
Form	SMA-111-2	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 900	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	900	309	41	550
Annual IC Time Burden (Hours)	176	60	8	108
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

Title	Document	Date Uploaded

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