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Management Reporting Tool
Performance Monitoring for Partnerships for Success (PFS)
OMB: 0930-0354
IC ID: 219387
OMB.report
HHS/SAMHSA
OMB 0930-0354
ICR 201512-0930-004
IC 219387
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0354 can be found here:
2021-09-27 - Revision of a currently approved collection
2018-07-25 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form Management Reporti
Management Reporting Tool
Form and Instruction
Management Reporti Management Reporting Tool
PeP-C_Wireframes_MRT_tool_6-10-2015_forCSAP.docx
Form and Instruction
Public_Burden_Statement-02022015.doc
Burden_Statement
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Management Reporting Tool
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 and Instruction
Management Reporting Tool
Management Reporting Tool
PeP-C_Wireframes_MRT_tool_6-10-2015_forCSAP.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
69
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 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
438
0
438
0
0
0
Annual IC Time Burden (Hours)
1,107
0
1,107
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Burden_Statement
Public_Burden_Statement-02022015.doc
12/22/2015
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.