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An Outcome Evaluation of the SOS Signs of Suicide Prevention Program
An Outcome Evaluation of the SOS Signs of Suicide Prevention Program
OMB: 0720-0047
IC ID: 191740
OMB.report
DOD/DODOASHA
OMB 0720-0047
ICR 201001-0720-002
IC 191740
( )
Documents and Forms
Document Name
Document Type
SOS Evaluation PI R. Aseltine Survey Versions 3C.pdf
Other-Survey
SOS English Consent 3a 2008-2009.doc
English Consent Form
IC Document
SOS Spanish Consent 3a 2008-2009.doc
Spanish Consent Form
IC Document
SOS Polish Consent 3a 2008-2009.doc
Polish Consent Form
IC Document
Privacy Act Statement SOS Evaluation PI R Aseltine-FINAL.doc
PAS
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
An Outcome Evaluation of the SOS Signs of Suicide Prevention Program
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
Other-Survey
SOS Evaluation PI R. Aseltine Survey Versions 3C.pdf
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Defense and National Security
Subfunction:
Operational Defense
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
840
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
1,680
0
1,680
0
0
0
Annual IC Time Burden (Hours)
840
0
840
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
English Consent Form
SOS English Consent 3a 2008-2009.doc
01/11/2010
Spanish Consent Form
SOS Spanish Consent 3a 2008-2009.doc
01/11/2010
Polish Consent Form
SOS Polish Consent 3a 2008-2009.doc
01/11/2010
PAS
Privacy Act Statement SOS Evaluation PI R Aseltine-FINAL.doc
01/11/2010
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.