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National Evaluation of the ATTC
National Evaluation of the Addicition Technology Transfer Centers (ATTC)
OMB: 0930-0294
IC ID: 184361
OMB.report
HHS/SAMHSA
OMB 0930-0294
ICR 200804-0930-001
IC 184361
( )
Documents and Forms
Document Name
Document Type
Form Instruments
National Evaluation of the ATTC
Form and Instruction
Instruments Instrument
Attachments B-N Data Collection Instruments3-10-08.pdf
Form and Instruction
Attachments A and O.pdf
Attachments A and O
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
National Evaluation of the ATTC
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
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
Instruments
Instrument
Attachments B-N Data Collection Instruments3-10-08.pdf
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:
6,294
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
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
7,551
0
7,551
0
0
0
Annual IC Time Burden (Hours)
4,118
0
4,118
0
0
0
Annual IC Cost Burden (Dollars)
101,904
0
101,904
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachments A and O
Attachments A and O.pdf
03/28/2008
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.