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Advisory Council Report
Protection and Advoccy of Individuals With Mental Illness (PAIMI) Annual Program Performance Report
OMB: 0930-0169
IC ID: 197697
OMB.report
HHS/SAMHSA
OMB 0930-0169
ICR 201705-0930-004
IC 197697
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0169 can be found here:
2023-06-23 - Revision of a currently approved collection
2020-04-02 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form ACR
Advisory Council Report
Form
ACR ACR
Attachment 3 ACR 2.23.17 .docx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Advisory Council Report
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
ACR
ACR
Attachment 3 ACR 2.23.17 .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:
57
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
57
0
0
0
0
57
Annual IC Time Burden (Hours)
570
0
0
0
0
570
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.