Information Collection

Combating Autism Act Initiative Evaluation - Improving State Systems of Care Program

IC 194886 under ICR 201010-0915-003 · OMB 0915-0335.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0335 can be found here:

Documents and Forms

Document Name Document Type
Form 001_CAAI_State Sys Combating Autism Act Initiative Evaluation - Improving State Systems of Care Program Form and Instruction
001_CAAI_State Sys 001_CAAI_State Systems Attachment H State Systems of Care SSI protocol 42210.docx Form and Instruction
002_CAAI_State Sys 002_CAAI_State Systems Attachment I - CAAI State Systems of Care Questionnaire.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Combating Autism Act Initiative Evaluation - Improving State Systems of Care Program	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	001_CAAI_State Systems	001_CAAI_State Systems	Attachment H State Systems of Care SSI protocol 42210.docx		Yes	Yes	Fillable Fileable
Form and Instruction	002_CAAI_State Systems	002_CAAI_State Systems	Attachment I - CAAI State Systems of Care Questionnaire.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 9	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	54	54
Annual IC Time Burden (Hours)	41	41
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.