Information Collection

2010 N-mhss

IC 7528 under ICR 200912-0930-001 · OMB 0930-0119.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0119 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Attachment 1 - Que 2010 N-MHSS	Form and Instruction
Attachment 1 - Que Attachment 1 - Questionnaire Attachment 1.0_2010 N-MHSS Revised Questionnaire.doc	Form and Instruction
Attachment 2.0_2010 N-MHSS Public Comment re_60-Day FRN.doc Attachment 2 - Comments	IC Document
Attach3-6.zip Attachments 3-6	IC Document

IC Title:

2010 N-MHSS

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	Attachment 1 - Questionnaire	Attachment 1 - Questionnaire	Attachment 1.0_2010 N-MHSS Revised Questionnaire.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 13,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	13,000	8,390	4,610
Annual IC Time Burden (Hours)	13,000	8,390	4,610
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment 2 - Comments	Attachment 2.0_2010 N-MHSS Public Comment re_60-Day FRN.doc	12/07/2009
Attachments 3-6	Attach3-6.zip	12/07/2009

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