Information Collection Request

Heart of Recovery

ICR 202105-0702-001 · OMB 0702-0143 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
SSB Heart of Recovery_OMB 4-30-18.docx Supporting Statement B Uploaded 2021-05-21 Repair queued
0702-0143_SSA_5.13.2021.docx Supporting Statement A Uploaded 2021-05-21 Repair queued
Care Messaging Plan for OMB 4-30-18.docx Supplementary Document Uploaded 2018-05-01 Repair queued
OPA Approval.PDF Supplementary Document Uploaded 2018-02-08 Repair queued
R40_5.pdf Supplementary Document Uploaded 2018-02-02 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
231293 Heart Of Recovery Other-Survey Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 05/31/2021
5,000 5,000
2,500 2,500
40,000 40,000





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Heart Of Recovery

table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 5,000 5,000 0 0 0 0
Annual Time Burden (Hours) 2,500 2,500 0 0 0 0
Annual Cost Burden (Dollars) 40,000 40,000 0 0 0 0


Reginfo record details
  No