Mfp

Evaluation of SAMHSAs Minority Fellowship Program (MFP)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0304 can be found here:

Documents and Forms

Document Name Document Type
Form Attachments A-F MFP Form and Instruction
Attachments A-F Attachments A-F MFP_OMB_survey_and_interview_protocols_v5.doc Form and Instruction
MFP OMB_other information and resources.doc Attachments G & H IC Document

Information Collection (IC) Details

IC Title:	MFP	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 A-F	Attachments A-F	MFP_OMB_survey_and_interview_protocols_v5.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,015	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	1,015	1,015
Annual IC Time Burden (Hours)	1,950	1,950
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachments G & H	MFP OMB_other information and resources.doc	05/19/2009

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