ATTC - Event Description Form

National Cross-Site Assessment of Addiction Technology Transfer Centers (ATTC) Network

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0216 can be found here:

Documents and Forms

Document Name Document Type
Form Event Description ATTC - Event Description Form Form and Instruction
Event Description Event Description Form Attachment.1.Event.Description.Form.doc Form and Instruction
Other.zip Other Attachments IC Document

Information Collection (IC) Details

IC Title:	ATTC - Event Description Form	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	Event Description Form	Event Description Form	Attachment.1.Event.Description.Form.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 250	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 10 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	250	50	200
Annual IC Time Burden (Hours)	63	13	50
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Other Attachments	Other.zip	01/27/2010

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