Information Collection

Addressing Barriers to Mental Health Care for Active-Duty Sexual Trauma Survivors

IC 271082 under ICR 202511-0704-005 · OMB 0704-0644.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Facilitators Guide_Site Visits.docx	Other-Facilitator Guide
Facilitators Guide_Site Visits.docx	Other-Facilitator Guide
0704-0644_SSA_Listening Sessions_9.20.24.docx Supporting Statement A	IC Document
0704-0644_SSA_Listening Sessions_9.20.24.docx Supporting Statement A	IC Document

IC Title:

Agency IC Tracking Number:

IC Status: Unchanged

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
Other-Facilitator Guide					No		Paper Only

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	500	500
Annual IC Cost Burden (Dollars)	24,535	24,535

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement A		09/20/2024

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

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