OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

State and Territory Survey

IC 217164 under ICR 201506-0990-003 · OMB 0990-0441.

Documents and Forms
Document Name
Document Type
Other-survey
Other-survey
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

State and Territory Survey
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-survey 0990-OMH Attachment B - Interview Topics and Data Collection Tables Handout 7-31-15 final.docx No   Fillable Printable
Other-survey 0990-Attachment A - OMH State and Territorial Survey final Edits.61915.docx No   Fillable Printable

Health Health Care Services

 

54 0
   
State, Local, and Tribal Governments
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 54 0 54 0 0 0
Annual IC Time Burden (Hours) 81 0 81 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attachment C 0990 OMH Attachment C - Technical Expert Panel Membership Roster.JNG Edits 6915.docx 10/20/2015
Introductory letter 0990-OMH_Attachment D - Introductory Letters.61915 final.docx 10/20/2015
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.