Community Mental Health Services Block Grant Application Guidance and Instructions, FY 2009-2011

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0168 can be found here:

Documents and Forms

Document Name Document Type
Form Attachment 4 - App Community Mental Health Services Block Grant Application Guidance and Instructions, FY 2009-2011 Form and Instruction
Attachment 4 - App Attachment 4 - Application Attachment-4-FINAL Application 4-4 No Watermark.doc Form and Instruction
Attachment-5-Commissioner Transmittal Ltr OMB Final.doc Attachment 5 - Letter IC Document
Attachments-1-3.doc Attachment 1-3 - Comments IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Community Mental Health Services Block Grant Application Guidance and Instructions, FY 2009-2011	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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 4 - Application	Attachment 4 - Application	Attachment-4-FINAL Application 4-4 No Watermark.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 59	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 59 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	59	0	59
Annual IC Time Burden (Hours)	15,710	-885	16,595
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment 5 - Letter	Attachment-5-Commissioner Transmittal Ltr OMB Final.doc	05/05/2008
Attachment 1-3 - Comments	Attachments-1-3.doc	05/05/2008

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