Monitoring of National Suicide Prevention Lifeline Form

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0274 can be found here:

Documents and Forms

Document Name Document Type
Form Instruments Monitoring of National Suicide Prevention Lifeline Form Form and Instruction
Instruments Attachments A D E H J K Instruments.zip Form and Instruction
Other Documents.zip Other Docs - Attachments B C F G I IC Document
Published FRN.pdf Published FRN IC Document
Signed EE Memo.pdf Signed EE Memo IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Monitoring of National Suicide Prevention Lifeline Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	Instruments	Attachments A D E H J K	Instruments.zip		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,471	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,436	3,436
Annual IC Time Burden (Hours)	1,181	1,181
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Other Docs - Attachments B C F G I	Other Documents.zip	04/16/2009
Published FRN	Published FRN.pdf	08/24/2012
Signed EE Memo	Signed EE Memo.pdf	08/24/2012

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