Campus Staff - Campus Case

Cross-Site Evaluation of the Garrett Lee Smith Memorial Suicide Prevention and Early Intervention Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0286 can be found here:

Documents and Forms

Document Name Document Type
Form Campus Staff Instr Campus Staff - Campus Case Form and Instruction
Campus Staff Instr Campus Staff Instruments A13 CCS - Campus Staff Instruments.pdf Form and Instruction
A14 CCS - Campus Staff Supporting Documents.pdf Campus Staff Supporting Documents IC Document

Information Collection (IC) Details

IC Title:	Campus Staff - Campus Case	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	Campus Staff Instruments	Campus Staff Instruments	A13 CCS - Campus Staff Instruments.pdf		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 152	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,064	1,064
Annual IC Time Burden (Hours)	206	206
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Campus Staff Supporting Documents	A14 CCS - Campus Staff Supporting Documents.pdf	06/03/2010

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