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Community Mental Health Centers (cmhc) Construction Grantee Checklist
COMMUNITY MENTAL HEALTH CENTERS (CMHC) CONSTRUCTION GRANTEE CHECKLIST
OMB: 0930-0104
IC ID: 111948
OMB.report
HHS/SAMHSA
OMB 0930-0104
ICR 199202-0930-001
IC 111948
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0104 can be found here:
2004-05-24 - Extension without change of a currently approved collection
2001-04-26 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
COMMUNITY MENTAL HEALTH CENTERS (CMHC) CONSTRUCTION GRANTEE CHECKLIST
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Migrated
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
ADM 593
No
No
Form
04/91
No
No
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
389
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
389
0
-50
0
0
439
Annual IC Time Burden (Hours)
130
0
20
0
0
110
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.