Information Collection

Brother Your On My Mind (BYOMM) Knowledge Attitudes and Belief (KAB) (NIMHD)

IC 236608 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⚠️ Notice: This information collection may be referencing outdated material.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 Brother Your On My Mind (BYOMM) Knowledge Attitudes and Belief (KAB) (NIMHD)	Form and Instruction
1 BYOMM KAB BYOMM KAB--06-19-2019.pdf	Form and Instruction
Fast Track OMB Clerarance - Updated 06-18-2019.docx Fast track BYOMM KAB	IC Document

IC Title:

Brother Your On My Mind (BYOMM) Knowledge Attitudes and Belief (KAB) (NIMHD)

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	BYOMM KAB	BYOMM KAB--06-19-2019.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 600

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	600	600
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast track BYOMM KAB	Fast Track OMB Clerarance - Updated 06-18-2019.docx	06/21/2019

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