Information Collection

Behavioral Health Data for Response Efforts: Interviews with Non-governmental Organizations (CSELS)

IC 228864 under ICR 201611-0920-005 · OMB 0920-1158.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1158 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Behavioral Health Data for Response Efforts: Interviews with Non-governmental Organizations (CSELS)	Form and Instruction
Interview Guide and Questions for Non-governmental Organ Interview Guide Behav Hlth Data Response NGO_10312017.docx	Form and Instruction
Template Behav Health Data for Response NGOs_10312017.docx I-Catalyst Template	IC Document
SS-A Behav Health Data for Response NGOs_10312017.docx SS-A Behavioral Health Data Interviews with NGO	IC Document

IC Title:

Behavioral Health Data for Response Efforts: Interviews with Non-governmental Organizations (CSELS)

Agency IC Tracking Number:

0920-18DN

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	n/a	Interview Guide and Questions for Non-governmental Organizations	Interview Guide Behav Hlth Data Response NGO_10312017.docx		No		Paper Only

Line of Business: Disaster Management

Subfunction: Emergency Response

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	900	900

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
I-Catalyst Template	Template Behav Health Data for Response NGOs_10312017.docx	10/31/2017
SS-A Behavioral Health Data Interviews with NGO	SS-A Behav Health Data for Response NGOs_10312017.docx	10/31/2017

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.