National Institute of Mental Health (NIMH) Outreach Partnership Program Annual Meeting Assessment Form

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NIH)

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form 1 National Institute of Mental Health (NIMH) Outreach Partnership Program Annual Meeting Assessment Form Form
1 2018 OPP Mtg Assessment Form 2018 OPP Mtg Assessment Form 6.8.18.doc Form
Request for OMB Clearance2 - Collection of Routine Customer Feedback (OPP Annual Meeting Assessment).docx OPP Annual Meeting Assessment fast track IC Document

Information Collection (IC) Details

IC Title:	National Institute of Mental Health (NIMH) Outreach Partnership Program Annual Meeting Assessment Form	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	2018 OPP Mtg Assessment Form	2018 OPP Mtg Assessment Form 6.8.18.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 82	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	82	82
Annual IC Time Burden (Hours)	14	14
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OPP Annual Meeting Assessment fast track	Request for OMB Clearance2 - Collection of Routine Customer Feedback (OPP Annual Meeting Assessment).docx	06/12/2018

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