Information Collection

CMHS Program-Level Data

IC 213385 under ICR 201410-0930-001 · OMB 0930-0346.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0346 can be found here:

Documents and Forms

Document Name Document Type
Form IPP_RESULT FORM CMHS Program-Level Data Form
IPP_RESULT FORM IPP_RESULT FORM Attachment 3 IPP_RESULT FORM.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	CMHS Program-Level Data	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	IPP_RESULT FORM	IPP_RESULT FORM	Attachment 3 IPP_RESULT FORM.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 982	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,928	3,928
Annual IC Time Burden (Hours)	7,856	7,856
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.