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SOAR Data Form - Part II
SAMHSA SOAR Web-Based Data Form
OMB: 0930-0329
IC ID: 226017
OMB.report
HHS/SAMHSA
OMB 0930-0329
ICR 201912-0930-004
IC 226017
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0329 can be found here:
2023-01-24 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form Part II
SOAR Data Form - Part II
Form and Instruction
Part II Part II
Attachment B- Part II- SOAR Data Form 11-18-19 FINAL.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
SOAR Data Form - Part II
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
Part II
Part II
Attachment B- Part II- SOAR Data Form 11-18-19 FINAL.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:
75
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
75
0
0
0
0
75
Annual IC Time Burden (Hours)
38
0
0
0
0
38
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.