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Infrastructure, Development, Prevention MH Abstraction
Transformation Accountability (TRAC) Reporting System
OMB: 0930-0285
IC ID: 192393
OMB.report
HHS/SAMHSA
OMB 0930-0285
ICR 201612-0930-003
IC 192393
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0285 can be found here:
2024-10-02 - Revision of a currently approved collection
2023-02-14 - No material or nonsubstantive change to a currently approved collection
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
View Information Collection (IC)
IC Title:
Infrastructure, Development, Prevention MH Abstraction
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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
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:
982
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
3,928
0
0
0
0
3,928
Annual IC Time Burden (Hours)
7,856
0
0
0
0
7,856
Annual IC Cost Burden (Dollars)
0
0
0
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.