Information Collection

The Nat'l Eval. of theComprehensive Community MH Services for Children - Caregivers

IC 190420 under ICR 201206-0930-002 · OMB 0930-0307.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0307 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Caregiver-Instrume The Nat'l Eval. of theComprehensive Community MH Services for Children - Caregivers	Form and Instruction
Caregiver-Instrume Caregiver-Instruments Caregiver--Instruments.pdf	Form and Instruction
Consultation.pdf Consultation	IC Document
Caregiver--Other.pdf Caregiver--Other	IC Document

IC Title:

The Nat'l Eval. of theComprehensive Community MH Services for Children - Caregivers

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	Caregiver-Instruments	Caregiver-Instruments	Caregiver--Instruments.pdf		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6,561

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	Previously Approved
Annual Number of Responses for this IC	67,039	-11,533	78,572
Annual IC Time Burden (Hours)	21,397	6,444	14,953
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Consultation	Consultation.pdf	09/10/2012
Caregiver--Other	Caregiver--Other.pdf	09/10/2012

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