Information Collection

National Outcome Measures for Substance Abuse Prevention

IC 7638 under ICR 200901-0930-001 · OMB 0930-0230.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0230 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Attachment D - Ins National Outcome Measures for Substance Abuse Prevention	Form and Instruction
Attachment D - Ins Attachment D - Instruments ATTACHMENT D NOMS Survey Forms revised.doc	Form and Instruction
ATTACHMENT A NOMs Change Table revised.doc Attachment A - Changes	IC Document
ATTACHMENT B NOMs Review revised.doc Attachment B - Review Experts	IC Document
ATTACHMENT C DACCC Privacy Protection Statement revised.doc Attachment C - Privacy Protection Statement	IC Document

IC Title:

National Outcome Measures for Substance Abuse Prevention

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:

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	Attachment D - Instruments	Attachment D - Instruments	ATTACHMENT D NOMS Survey Forms revised.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10,196

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 80 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	183,780	183,534	246
Annual IC Time Burden (Hours)	19,523	19,104	419
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment A - Changes	ATTACHMENT A NOMs Change Table revised.doc	01/07/2009
Attachment B - Review Experts	ATTACHMENT B NOMs Review revised.doc	01/07/2009
Attachment C - Privacy Protection Statement	ATTACHMENT C DACCC Privacy Protection Statement revised.doc	01/07/2009

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