Information Collection

Standard Feedback Survey for the National Center for Health, Behavioral Health, and Safety's Training and Technical Assistance Offerings

IC 275040 under ICR 202607-0970-013 · OMB 0970-0401.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Both_Standard Feedback Survey for the NCHBHS TTA Offerings_2.4.25 clean (1).docx	Other-Survey
OMB form_revised Standard Survey_1.12.22-clean.docx Submission Form - Standard Feedback Survey for the NCHBHS TTA Offerings	IC Document

IC Title:

Agency IC Tracking Number:

IC Status: Modified

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-Survey					Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 63,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	63,000	63,000
Annual IC Time Burden (Hours)	5,250	5,250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Submission Form - Standard Feedback Survey for the NCHBHS TTA Offerings		04/25/2025

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

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