Drug and Alcohol Services Information System - States

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⚠️ Notice: This information collection may be referencing outdated material.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 Instruments Drug and Alcohol Services Information System - States Form and Instruction
Instruments Instruments DASIS OMB - Instruments.zip Form and Instruction
DASIS OMB - Other.zip Other IC Document

Information Collection (IC) Details

IC Title:	Drug and Alcohol Services Information System - States	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	DASIS OMB - Instruments.zip		No	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 56	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,920	3,920
Annual IC Time Burden (Hours)	3,380	3,380
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Other	DASIS OMB - Other.zip	08/03/2009

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