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National Evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program: Phase Four
National Evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program: Phase Four
OMB: 0930-0257
IC ID: 7672
OMB.report
HHS/SAMHSA
OMB 0930-0257
ICR 200704-0930-002
IC 7672
( )
Documents and Forms
Document Name
Document Type
Form Attachment 4
National Evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program: Phase Four
Form and Instruction
Attachment 4 Attachment 4
Attachment 4 - Surveys.ZIP
Form and Instruction
Attachments 1, 2, 3, 5, 6.ZIP
Attachments 1, 2, 3, 5, 6
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
National Evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program: Phase Four
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
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
Attachment 4
Attachment 4
Attachment 4 - Surveys.ZIP
Yes
Yes
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
3,374
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
50 %
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
11,539
0
-39,754
0
0
51,293
Annual IC Time Burden (Hours)
6,281
0
-18,981
0
0
25,262
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachments 1, 2, 3, 5, 6
Attachments 1, 2, 3, 5, 6.ZIP
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.