Information Collection

Pretesting of Substance Abuse Prevention and Treatment and Mental Health Services Communications Messages

IC 179707 under ICR 200704-0930-007 · OMB 0930-0196.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0196 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Justification and Pretesting of Substance Abuse Prevention and Treatment and Mental Health Services Communications Messages	Form and Instruction
OMBTranLet5.wpd	Instruction
Justification and Justification and Survey Suicide-5-March30.doc	Form and Instruction

IC Title:

Pretesting of Substance Abuse Prevention and Treatment and Mental Health Services Communications Messages

Agency IC Tracking Number:

IC Status: New

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	Justification and Survey	Justification and Survey	Suicide-5-March30.doc		Yes	Yes	Paper Only
Instruction			OMBTranLet5.wpd		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 11,700

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	11,700	0	0	0	0	0
Annual IC Time Burden (Hours)	9,290	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	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.