State Data User Survey

National Survey on Drug Use and Health: Methodological Field Tests

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0290 can be found here:

Documents and Forms

Document Name Document Type
Form Attachment B - Sur State Data User Survey Form and Instruction
Attachment B - Sur Attachment B - Survey Attachment B - Web-Based Survey Questionnaire.doc Form and Instruction
Attachment A - Email Requesting Participation.doc Attachment A - Email for Participation IC Document
Attachment D - Second Reminder Email.doc Attachment D - 2nd Reminder IC Document
Attachment C - First Reminder Email.doc Attachment C - 1st Reminder IC Document
Supporting Statement.doc Justification IC Document
data user omb memo.doc Memo IC Document

Information Collection (IC) Details

IC Title:	State Data User Survey	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Attachment B - Survey	Attachment B - Survey	Attachment B - Web-Based Survey Questionnaire.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 65	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	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	65	0	0	0	0	0
Annual IC Time Burden (Hours)	16	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment A - Email for Participation	Attachment A - Email Requesting Participation.doc	04/24/2008
Attachment D - 2nd Reminder	Attachment D - Second Reminder Email.doc	04/24/2008
Attachment C - 1st Reminder	Attachment C - First Reminder Email.doc	04/24/2008
Justification	Supporting Statement.doc	04/24/2008
Memo	data user omb memo.doc	04/24/2008

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