BRSS TACS TA Survey

Voluntary Customer Satisfaction Surveys to Implement Executive Order 12862 in the Substance Abuse and Mental Health Services Administration (SAMHSA)

OMB: 0930-0197

IC ID: 225381

Information Collection (IC) Details

View Information Collection (IC)

BRSS TACS TA Survey
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction BRSS TACS TA Survey BRSS TACS TA Survey BRSS TACS_OMB Attachment A Satisfaction Survey_011117.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

500 0
   
State, Local, and Tribal Governments
 
   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 500 0 500 0 0 0
Annual IC Time Burden (Hours) 100 0 100 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Email to Respondents BRSS TACS_OMB Attachment B Email to Respondents_12-21-16.docx 01/27/2017
Screenshots BRSS TACS_OMB Attachment C Screenshots_12-21-16.docx 01/27/2017
Supporting Statement BRSS TACS_OMB Supporting Statement_1.12.17.docx 01/27/2017
Transmittal Letter Trans.Let-1-2017.doc 01/27/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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