Information Collection

Reporting - Opioid Treatment Programs

IC 37857 under ICR 202408-0930-004 · OMB 0930-0206.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SMA-162 Reporting - Opioid Treatment Programs	Form and Instruction
Form SMA-162 SMA-162 Reporting - Opioid Treatment Programs	Form and Instruction
Form SMA-168 SMA-168 Reporting - Opioid Treatment Programs	Form and Instruction
SMA-162 SMA-162 Opioid regs OMB_FORM_SMA-162.docx	Form and Instruction
SMA-162 SMA-162 Opioid regs OMB_FORM_SMA-162.docx	Form and Instruction
SMA-168 SMA-168 Opioid regs OMB_FORM_SMA-168.docx	Form and Instruction
SMA-168 SMA-168 Opioid regs OMB_FORM_SMA-168.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

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	SMA-162				Yes	Yes	Fillable Fileable
Form and Instruction	SMA-168				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,054

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	Previously Approved
Annual Number of Responses for this IC	36,925	1,798	35,127
Annual IC Time Burden (Hours)	2,954	52	2,902
Annual IC Cost Burden (Dollars)	0	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.

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