Information Collection

Infrastructure, Development, Prevention MH Abstraction

IC 192393 under ICR 201003-0930-005 · OMB 0930-0285.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0285 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att3. Infrastructure, Prevention and MH Promotion Indicators 9-2-09.doc	Instruction

IC Title:

Infrastructure, Development, Prevention MH Abstraction

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
Instruction			Att3. Infrastructure, Prevention and MH Promotion Indicators 9-2-09.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 942

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	3,768	3,768
Annual IC Time Burden (Hours)	15,072	15,072
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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