SAMHSA Fetal Alcohol Spectrum Disorders Center for Excellence Screening and Brief Intervention Evaluation

ICR 200905-0930-001

OMB: 0930-0302

Federal Form Document

Forms and Documents
ICR Details
0930-0302 200905-0930-001
Historical Active
HHS/SAMHSA
SAMHSA Fetal Alcohol Spectrum Disorders Center for Excellence Screening and Brief Intervention Evaluation
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 07/21/2009
Retrieve Notice of Action (NOA) 05/11/2009
Approved consistent with modified documents uploaded on 7/21/2009.
  Inventory as of this Action Requested Previously Approved
07/31/2012 36 Months From Approved
17,998 0 0
3,771 0 0
0 0 0

The purpose of the Fetal Alcohol Spectrum Disorders (FASD) Center for Excellence Screening and Brief Intervention (SBI) project is to prevent alcohol exposed pregnancies among women of child bearing age and pregnant women; and improve the quality of life for individuals affected by FASD.

US Code: 5 USC 501 Name of Law: SAMHSA
  
None

Not associated with rulemaking

  73 FR 64620 10/30/2008
74 FR 21376 05/07/2009
No

1
IC Title Form No. Form Name
SAMHSA Fetal Alcohol Spectrum Disorders Center for Excellence Screening and Brief Intervention Evaluation Attachment 1 - Instruments Attachment 1 - Instruments

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 17,998 0 0 17,998 0 0
Annual Time Burden (Hours) 3,771 0 0 3,771 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new data collection.

$1,206,486
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
No
Uncollected
Summer King 2402761243

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
05/11/2009


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