Information Collection

National Evaluation of the Comprehensive Mental Health Services for Children and their families program: Phase V

IC 43646 under ICR 200702-0930-001 · OMB 0930-0280.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0280 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Attachments National Evaluation of the Comprehensive Mental Health Services for Children and their families program: Phase V	Form and Instruction
Attachments Attachments Attachments.zip	Form and Instruction

IC Title:

National Evaluation of the Comprehensive Mental Health Services for Children and their families program: Phase V

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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 and Instruction	Attachments	Attachments	Attachments.zip		No	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 572

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	572	-76,675	77,247
Annual IC Time Burden (Hours)	4,656	-18,624	23,280
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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