Information Collection

Monitoring of National Suicide Prevention Lifeline Form

IC 7689 under ICR 201208-0930-003 · OMB 0930-0274.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

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	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 %

table that charts list of burden
	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

table that charts IC Documents
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.