Infrastructure, Development, Prevention MH Abstraction

Transformation Accountability (TRAC) Reporting System

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0285 can be found here:

Documents and Forms

Document Name Document Type
Form Result Form Infrastructure, Development, Prevention MH Abstraction Form and Instruction
Result Form Result Form Attachment 3 IPP_RESULT FORM.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Infrastructure, Development, Prevention MH Abstraction	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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 and Instruction	Result Form	Result Form	Attachment 3 IPP_RESULT FORM.docx		Yes	Yes	Paper Only

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,928	160	3,768
Annual IC Time Burden (Hours)	7,856	-7,216	15,072
Annual IC Cost Burden (Dollars)	0	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.