Information Collection

Web Site Registration Survey

IC 194259 under ICR 202301-0930-004 · OMB 0930-0313.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Web Site Registrat Web Site Registration Survey	Form and Instruction
Web Site Registrat Web Site Registration Survey Questions (Attachment 1) SAMHSA_Web Site Registration Survey Questions_10.3.22_.docx	Form and Instruction
Web Site Registrat Web Site Registration Survey Questions (Attachment 1) SAMHSA_Web Site Registration Survey Questions_10.3.22_.docx	Form and Instruction
(Attachment 2) SAMHSA Main site v3 Survey_10.3.22_.docx (Attachment 2) SAMHSA Main site v3 Survey	IC Document
(Attachment 2) SAMHSA Main site v3 Survey_10.3.22_.docx (Attachment 2) SAMHSA Main site v3 Survey	IC Document
(Attachment 3) SAMHSA Store v2 Survey_10.3.22_.docx (Attachment 3) SAMHSA Store v2 Survey	IC Document
(Attachment 3) SAMHSA Store v2 Survey_10.3.22_.docx (Attachment 3) SAMHSA Store v2 Survey	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	Web Site Registration Survey Questions	Web Site Registration Survey Questions	(Attachment 1) SAMHSA_Web Site Registration Survey Questions_10.3.22_.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 21,082

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	21,082	21,082
Annual IC Time Burden (Hours)	696	696
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
(Attachment 2) SAMHSA Main site v3 Survey	(Attachment 2) SAMHSA Main site v3 Survey_10.3.22_.docx	01/23/2023
(Attachment 3) SAMHSA Store v2 Survey	(Attachment 3) SAMHSA Store v2 Survey_10.3.22_.docx	01/23/2023

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