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Nat'll Eval. of the Comprehensive MH Services for Children and Their Families Program - Community Staff
National Evaluation of the Comprehensive Mental Health Services for Children and Their Families Program: Phase V
OMB: 0930-0280
IC ID: 190262
OMB.report
HHS/SAMHSA
OMB 0930-0280
ICR 200908-0930-002
IC 190262
( )
Documents and Forms
Document Name
Document Type
Form Instruments
Nat'll Eval. of the Comprehensive MH Services for Children and Their Families Program - Community Staff
Form and Instruction
Instruments Instruments
CMHI Phase V OMB Re-Submission_INSTRUMENTS.zip
Form and Instruction
CMHI Phase V OMB Re-Submission_ATTACHMENTS.zip
Attachments
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Nat'll Eval. of the Comprehensive MH Services for Children and Their Families Program - Community Staff
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
Instruments
CMHI Phase V OMB Re-Submission_INSTRUMENTS.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:
870
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
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
20,944
0
20,944
0
0
0
Annual IC Time Burden (Hours)
18,012
0
18,012
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachments
CMHI Phase V OMB Re-Submission_ATTACHMENTS.zip
08/05/2009
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.