Information Collection

Targeted Capacity Expansion Grants for Jail Diversion Programs

IC 7692 under ICR 200704-0930-001 · OMB 0930-0277.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0277 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Attachment A Targeted Capacity Expansion Grants for Jail Diversion Programs	Form and Instruction
Attachment A Baseline Interview Appendix A - JailDiversionTCE_Baseline_Revised2006.doc	Form and Instruction
Attachment B 6-Month Interview Appendix B - JailDiversionTCE_6Month_Revised2006.doc	Form and Instruction
Attachment C 12-Month Interview Appendix C - JailDiversionTCE_12-Month_Revised2006.doc	Form
Attachment D Arrest Data Collection Form Appendix D - JailDiversionTCE_ArrestForm.doc	Form and Instruction
Attachment E MH and SA Collection Form Appendix E - JailDiversionTCE_ServiceUseForm.doc	Form and Instruction
Attachment G Baseline Person Tracking Info Form Appendix G - JailDiversionTCE_PersonTrackingForm.doc	Form and Instruction
Appendix F - Example of an Informed Consent Form.doc Attachment F- Consent Form	IC Document
Appendix H - Follow-up Interview Reminder Letter (template).doc Attachment H- Follow-up Letter	IC Document

IC Title:

Targeted Capacity Expansion Grants for Jail Diversion Programs

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Attachment A	Baseline Interview	Appendix A - JailDiversionTCE_Baseline_Revised2006.doc	Yes	Yes	Paper Only
Form and Instruction	Attachment B	6-Month Interview	Appendix B - JailDiversionTCE_6Month_Revised2006.doc	Yes	Yes	Paper Only
Form	Attachment C	12-Month Interview	Appendix C - JailDiversionTCE_12-Month_Revised2006.doc	Yes	Yes	Paper Only
Form and Instruction	Attachment D	Arrest Data Collection Form	Appendix D - JailDiversionTCE_ArrestForm.doc	Yes	Yes	Paper Only
Form and Instruction	Attachment E	MH and SA Collection Form	Appendix E - JailDiversionTCE_ServiceUseForm.doc	Yes	Yes	Paper Only
Form and Instruction	Attachment G	Baseline Person Tracking Info Form	Appendix G - JailDiversionTCE_PersonTrackingForm.doc	Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 686

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	21,869	-5,025	26,894
Annual IC Time Burden (Hours)	1,225	-148	1,373
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment F- Consent Form	Appendix F - Example of an Informed Consent Form.doc
Attachment H- Follow-up Letter	Appendix H - Follow-up Interview Reminder Letter (template).doc

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