Information Collection

National Institute of Mental Health (NIMH) Professional Coalition for Research Progress Meeting Assessment Form

IC 230698 under ICR 201802-0925-002 · OMB 0925-0648.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 National Institute of Mental Health (NIMH) Professional Coalition for Research Progress Meeting Assessment Form	Form and Instruction
1 NIMH Professional Coalition for Research Progress Meetin NIMH Professional Coalition for Research Progress Meeting Assessment Form for OMB Clearance.doc	Form and Instruction
Request for OMB Clearance - Collection of Routine Customer Feedback (NIMH Coalition Meeting).docx National Institute of Mental Health (NIMH) Professional Coalition for Research Progress Meeting Assessment Form	IC Document

IC Title:

National Institute of Mental Health (NIMH) Professional Coalition for Research Progress Meeting Assessment Form

Agency IC Tracking Number:

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	1	NIMH Professional Coalition for Research Progress Meeting Assessment Form	NIMH Professional Coalition for Research Progress Meeting Assessment Form for OMB Clearance.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 65

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	65	65
Annual IC Time Burden (Hours)	2	2
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
National Institute of Mental Health (NIMH) Professional Coalition for Research Progress Meeting Assessment Form	Request for OMB Clearance - Collection of Routine Customer Feedback (NIMH Coalition Meeting).docx	03/13/2018

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