Information Collection

Drug and Alcohol Services Information System - Facilities

IC 7513 under ICR 200908-0930-004 · OMB 0930-0106.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0106 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Instruments Drug and Alcohol Services Information System - Facilities	Form and Instruction
Instruments Instruments DASIS OMB - Instruments.zip	Form and Instruction
DASIS OMB - Other.zip Other	IC Document

IC Title:

Drug and Alcohol Services Information System - Facilities

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	DASIS OMB - Instruments.zip		No	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 20,200

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	20,200	-2,616	22,816
Annual IC Time Burden (Hours)	12,326	-2,314	14,640
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Other	DASIS OMB - Other.zip	08/03/2009

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