Monitoring of National Suicide Prevention Lifeline Form

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0274 can be found here:

Documents and Forms

Document Name Document Type
Form Instruments Monitoring of National Suicide Prevention Lifeline Form Form and Instruction
Instruments Attachments A D E H J K Instruments.zip Form and Instruction
Other Documents.zip Other Docs - Attachments B C F G I IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Monitoring of National Suicide Prevention Lifeline Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	Instruments	Attachments A D E H J K	Instruments.zip		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,471	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	3,436	3,070	366
Annual IC Time Burden (Hours)	1,181	917	264
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Other Docs - Attachments B C F G I	Other Documents.zip	04/16/2009

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