Information Collection

Rural Communities Opioid Response Program-Psychostimulant Support

IC 252017 under ICR 202306-0906-002 · OMB 0906-0044.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0906-0044 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 2 Rural Communities Opioid Response Program-Psychostimulant Support	Form and Instruction
2 Rural Communities Opioid Response Program-Psychostimulan RCORP-Psychostimulant Measures.docx	Form and Instruction
2 Rural Communities Opioid Response Program-Psychostimulan RCORP-Psychostimulant Measures.docx	Form and Instruction

IC Title:

Rural Communities Opioid Response Program-Psychostimulant Support

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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
Form and Instruction	2	Rural Communities Opioid Response Program-Psychostimulant Support	RCORP-Psychostimulant Measures.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 15

Number of Respondents for Small Entity: 15

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	15	15
Annual IC Time Burden (Hours)	20	20
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.