Benchmark Tool

Children’s Mental Health Initiative National Evaluation

OMB: 0930-0375

IC ID: 226025

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Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Financial Mapping Interview Financial Mapping Interview Attachment 6 Financial Mapping Interview 10-06-2016.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

12 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 12 0 12 0 0 0
Annual IC Time Burden (Hours) 320 0 320 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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