OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

DoDSER Suicide Event Report

IC 213137 under ICR 201907-0720-001 · OMB 0720-0058.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
dodser2014_itembank_FINAL.docx
dodser.t2.health.mil/ 		Other-Data Fields
DoDSER PAS Disclosure.docx Other-Privacy Act Statement
DoDSER Data Collection Phone Script.docx Other-Phone Script
DoDSER Initial Log On and Intro Screen Shots.pdf Other-Log on and Introductory Screen

Information Collection (IC) Details

View Information Collection (IC)

layout table

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
Other-Data Fields dodser2014_itembank_FINAL.docx https://dodser.t2.health.mil/ Yes Yes Fillable Fileable
Other-Privacy Act Statement DoDSER PAS Disclosure.docx Yes Yes Fillable Fileable
Other-Phone Script DoDSER Data Collection Phone Script.docx Yes Yes Fillable Fileable
Other-Log on and Introductory Screen Shots DoDSER Initial Log On and Intro Screen Shots.pdf Yes Yes Fillable Fileable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  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 1,563 0 188 0 0 1,375
Annual IC Time Burden (Hours) 261 0 32 0 0 229
Annual IC Cost Burden (Dollars) 5,580 0 2,314 0 0 3,266

Documents for IC
table that charts IC Documents
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.