Information Collection

Supported Employment Program (SEP) Programmatic Progress Report (PPR)

IC 264639 under ICR 202306-0930-004 · OMB 0930-0395.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMHS PPR Template Supported Employment Program (SEP) Programmatic Progress Report (PPR)	Form and Instruction
CMHS PPR Template CMHS PPR Template CMHS PPR Template - SEP_2023_1_Form.pdf	Form and Instruction
0930-0395 - SEP_2023_1.docx SEP PPR Grants Generic Template	IC Document

IC Title:

Agency IC Tracking Number:

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	CMHS PPR Template	CMHS PPR Template	CMHS PPR Template - SEP_2023_1_Form.pdf		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: 6

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	30	30
Annual IC Time Burden (Hours)	240	240
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SEP PPR Grants Generic Template	0930-0395 - SEP_2023_1.docx	01/24/2024

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