Information Collection

Nat'll Eval. of the Comprehensive MH Services for Children and Their Families Program - Community Staff

IC 190262 under ICR 200908-0930-002 · OMB 0930-0280.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Instruments Nat'll Eval. of the Comprehensive MH Services for Children and Their Families Program - Community Staff	Form and Instruction
Instruments Instruments CMHI Phase V OMB Re-Submission_INSTRUMENTS.zip	Form and Instruction
CMHI Phase V OMB Re-Submission_ATTACHMENTS.zip Attachments	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

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	Instruments	Instruments	CMHI Phase V OMB Re-Submission_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: 870

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	20,944	20,944
Annual IC Time Burden (Hours)	18,012	18,012
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachments	CMHI Phase V OMB Re-Submission_ATTACHMENTS.zip	08/05/2009

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