Information Collection

Mental Health Demonstration grant program

IC 235554 under ICR 202009-1894-003 · OMB 1894-0006.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1894-0006 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
MH_Demonstration_Grant_3-25-19_NIA.docx	Other-NIA
Mental_Health_83-C.pdf Change Justification	IC Document

IC Title:

Mental Health Demonstration grant program

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

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
Other-NIA			MH_Demonstration_Grant_3-25-19_NIA.docx		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	4,000	4,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Change Justification	Mental_Health_83-C.pdf	04/02/2019

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