Drug and Alcohol Services Information System

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0106 can be found here:

Documents and Forms

Document Name Document Type
Form Attachment B2 Drug and Alcohol Services Information System Form and Instruction
Attachment B2 2007 Questionnaire OMB Att-B2 2007 Questionnaire.pdf Form and Instruction
Attachment B1 Mark-up 2006 OMB Att-B1 Markup 2006 Questionnaire.pdf Form and Instruction
Attachment B4 2007 CATI Questionnaire OMB Att B4 CATI.pdf Form and Instruction
Attachment B5 Mini 2007 CATI Questionnaire OMB Att B5 Mini CATI.pdf Form and Instruction
Attachment B3 2007 Web Screen On-line Questionnaire Attachment B-3 Combined..zip Form and Instruction
OMB Att B6 AdvanceLtr_20071.pdf Attachment B6 - 2007 Advance Letter IC Document
Attachment A.zip Attachment A IC Document
terms memo.wpd Terms of Clearance Memo IC Document
OMB Att B7 CoverLtr1stWebFlyFAQ_20071.pdf Attachment B7 - 2007 Cover Letter IC Document
OMB Att B8 TkYou-ReminderLtr_20071.pdf Attachment B8 - 2007 Thank You Letter IC Document
OMB Att B9 2ndQuexCoverLtr_2007.pdf Attachment B9 - 2007 2nd Cover Letter IC Document
OMB Att B10 - MiniAdvanceLtr.pdf Attachment B10 - 2007 Mini Advance Letter IC Document
OMB Att-B11 2007 Info Website.pdf Attachment B11 - Info Website IC Document
Attachment C1 - 60-day FR notice .pdf Attachment C1 - 60-Day FR Notice IC Document
OMB Att C2 List of Pretest Respondents.pdf Attachment C2 - Pretest Respondents IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Drug and Alcohol Services Information System	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Attachment B2	2007 Questionnaire	OMB Att-B2 2007 Questionnaire.pdf	Yes	Yes	Paper Only
Form and Instruction	Attachment B1	Mark-up 2006	OMB Att-B1 Markup 2006 Questionnaire.pdf	Yes	Yes	Paper Only
Form and Instruction	Attachment B4	2007 CATI Questionnaire	OMB Att B4 CATI.pdf	Yes	Yes	Paper Only
Form and Instruction	Attachment B5	Mini 2007 CATI Questionnaire	OMB Att B5 Mini CATI.pdf	Yes	Yes	Paper Only
Form and Instruction	Attachment B3	2007 Web Screen On-line Questionnaire	Attachment B-3 Combined..zip	Yes	Yes	Paper Only

Line of Business: Health

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 18,856	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	22,816	-109	-200	23,125
Annual IC Time Burden (Hours)	14,640	-10	8,159	6,491
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment B6 - 2007 Advance Letter	OMB Att B6 AdvanceLtr_20071.pdf	08/09/2006
Attachment A	Attachment A.zip	08/09/2006
Terms of Clearance Memo	terms memo.wpd	08/09/2006
Attachment B7 - 2007 Cover Letter	OMB Att B7 CoverLtr1stWebFlyFAQ_20071.pdf	08/09/2006
Attachment B8 - 2007 Thank You Letter	OMB Att B8 TkYou-ReminderLtr_20071.pdf	08/09/2006
Attachment B9 - 2007 2nd Cover Letter	OMB Att B9 2ndQuexCoverLtr_2007.pdf	08/09/2006
Attachment B10 - 2007 Mini Advance Letter	OMB Att B10 - MiniAdvanceLtr.pdf	08/09/2006
Attachment B11 - Info Website	OMB Att-B11 2007 Info Website.pdf	08/09/2006
Attachment C1 - 60-Day FR Notice	Attachment C1 - 60-day FR notice .pdf	08/09/2006
Attachment C2 - Pretest Respondents	OMB Att C2 List of Pretest Respondents.pdf	08/09/2006

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