The Mental Health Transformation state Incentive Grant Cross-Site Evaluation

The Mental Health Transformation State Incentive Grant Cross-Site Evaluation

Documents and Forms

Document Name Document Type
Form Attachments 1-13 The Mental Health Transformation state Incentive Grant Cross-Site Evaluation Form and Instruction
Attachments 1-13 Attachments 1-13 Attachments-1-13.doc Form and Instruction

Information Collection (IC) Details

IC Title:	The Mental Health Transformation state Incentive Grant Cross-Site Evaluation	Agency IC Tracking Number:

Is this a Common Form? No		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	Attachments 1-13	Attachments 1-13	Attachments-1-13.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,133	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,133	2,133
Annual IC Time Burden (Hours)	1,586	1,586
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.