Survey of State Underage Drinking Prevention Policies and Practices

Forms and Documents

Document Name	Status
Form STOP State Survey State Survey Form and Instruction	Modified
OMB SS-B 2015-16 OMB 05.13.15.doc Supporting Statement B	2015-08-19
OMB SS-A 2015-16 OMB 06.17.15.doc Supporting Statement A	2015-08-19
Attachment 4 - Sample Letter to Governors 2015-2016 OMB 05 13 15.docx Supplementary Document	2015-08-19
Attachment 3 - Sample data tables for AL and AK 2015-2016 OMB 05 13 15.doc Supplementary Document	2015-08-19
Attachment 1 - ICCPUD Principals List 2015-2016 OMB 05 13 15.docx Supplementary Document	2015-08-19

IC Document Collections

IC ID	Document Title	Status
194214	State Survey Form and Instruction	Modified

ICR Details

OMB Control No: 0930-0316	ICR Reference No: 201508-0930-001
Status: Historical Active	Previous ICR Reference No: 201209-0930-001
Agency/Subagency: HHS/SAMHSA	Agency Tracking No:
Title: Survey of State Underage Drinking Prevention Policies and Practices
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/06/2015
	Date Received in OIRA: 08/24/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2018	36 Months From Approved	02/29/2016
Responses	51	0	51
Time Burden (Hours)	903	0	903
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of the data collection through the State Survey will be to create a compendium of the States' best practices and performances in enacting, enforcing, and creating laws, regulations, and programs to prevent or reduce underage drinking. Congress mandated the collection of these data to provide policymakers and the public with currently unavailable but much-needed information regarding State underage drinking prevention policies and programs.

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Authorizing Statute(s): US Code: 42 USC 290 Name of Law: Data Collection
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 34449	06/16/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 50642	08/20/2015
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
State Survey	STOP State Survey	STOP State Survey

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	51	51	0	0	0	0
Annual Time Burden (Hours)	903	903	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $268,694

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 08/24/2015

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