Information Collection

Reporting - Opioid Treatment Programs

IC 37857 under ICR 201303-0930-002 · OMB 0930-0206.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0206 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SMA-168 Reporting - Opioid Treatment Programs	Form and Instruction
SMA-162 SMA-162 SMA-162.pdf	Form and Instruction
SMA-168 SMA-168 SMA-168.pdf	Form and Instruction

IC Title:

Reporting - Opioid Treatment Programs

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

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	SMA-168	SMA-168	SMA-168.pdf		Yes	Yes	Fillable Printable
Form and Instruction	SMA-162	SMA-162	SMA-162.pdf		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,775

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	24,594	-5,981	0	30,575
Annual IC Time Burden (Hours)	1,869	-455	0	2,324
Annual IC Cost Burden (Dollars)	0	0	-450,000	450,000

Documents for IC

table that charts IC Documents
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.