Cross-Site Evaluation of the Garrett Lee Smith Memorial Suicide Prevention and Early Intervention Program

ICR 200701-0930-005

OMB: 0930-0286

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
New
Form and Instruction
New
Form and Instruction
New
Form and Instruction
New
Form and Instruction
New
Form and Instruction
New
Form and Instruction
New
Supplementary Document
2007-05-29
Supporting Statement B
2006-12-28
Supporting Statement A
2006-12-28
IC Document Collections
ICR Details
0930-0286 200701-0930-005
Historical Active
HHS/SAMHSA
Cross-Site Evaluation of the Garrett Lee Smith Memorial Suicide Prevention and Early Intervention Program
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 05/30/2007
Retrieve Notice of Action (NOA) 01/24/2007
Approved consistent with revisions outlined in SAMHSA memo submitted to OMB.
  Inventory as of this Action Requested Previously Approved
05/31/2010 36 Months From Approved
26,229 0 0
6,331 0 0
0 0 0

The information collected through the four stages of the cross-site evaluation of the GLS Suicide Prevention and Early Intervention Programs will describe for State/Tribal grantees (1) the context in which suicide prevention activities are being implemented, (2) the products and services funded through the program, (3) the training experiences of individuals who receive training as part of the suicide prevention programs, (4) the utilization and penetration of the skills, knowledge and techniques learned through suicide prevention training programs, and (5) the referral networks in place to support youth identified at risk for suicide.

None
None

Not associated with rulemaking

  71 FR 34147 06/13/2006
71 FR 77769 12/27/2006
No

7
IC Title Form No. Form Name
GLS Surveys Surveys
GLS Surveys Surveys
GLS Surveys Surveys
GLS Surveys Surveys
GLS Surveys Surveys
GLS Surveys Surveys
GLS Surveys Surveys

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 26,229 0 44,590 -18,361 0 0
Annual Time Burden (Hours) 6,331 0 0 6,331 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
This is a new data collection.

$0
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected
Saleda Perryman

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
12/28/2006


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