Information Collection

988 Crisis Center Follow Up Cooperative Agreements

IC 260137 under ICR 202305-0930-001 · OMB 0930-0394.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0394 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Crisis Center Data 988 Crisis Center Follow Up Cooperative Agreements	Form and Instruction
Form Crisis Center Data 988 Crisis Center Follow Up Cooperative Agreements	Form and Instruction
Crisis Center Data Crisis Center Data Reporting Elements Data Reporting Elements 4.5.23.docx	Form and Instruction
Crisis Center Data Crisis Center Data Reporting Elements Data Reporting Elements 4.5.23.docx	Form and Instruction
Crisis Center Mont Crisis Center Monthly Agenda Template CCFU Instrument 1 _ Monthly Meeting Agenda 4.5.23.docx	Form and Instruction
Crisis Center Mont Crisis Center Monthly Agenda Template CCFU Instrument 1 _ Monthly Meeting Agenda 4.5.23.docx	Form and Instruction

IC Title:

988 Crisis Center Follow Up Cooperative Agreements

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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	Crisis Center Data Reporting Elements	Crisis Center Data Reporting Elements	Data Reporting Elements 4.5.23.docx		Yes	Yes	Fillable Fileable
Form and Instruction	Crisis Center Monthly Agenda Template	Crisis Center Monthly Agenda Template	CCFU Instrument 1 _ Monthly Meeting Agenda 4.5.23.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: Privacy Act of 1974 (Title 5 United States Code [U.S.C.] 552a)

FR Citation: 75 FR 28264

Number of Respondents: 20

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
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	40	40
Annual IC Cost Burden (Dollars)	0	0

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.