OMB
.report
Search
Client FG
Targeted Capacity Expansion Program for Substance Abuse Treatment and HIV/AIDS Services (TCE-HIV)
OMB: 0930-0317
IC ID: 194042
OMB.report
HHS/SAMHSA
OMB 0930-0317
ICR 201008-0930-001
IC 194042
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0317 can be found here:
2010-10-24 - New collection (Request for a new OMB Control Number)
Documents and Forms
Document Name
Document Type
Form Attachments 1a and
Client FG
Form and Instruction
Attachments 1a and Attachments 1a and 1b - Instruments
Attachments 1a and 1b.pdf
Form and Instruction
Attachments 2a, 2b, 2c, and 2d.pdf
Attachments 2a, 2b, 2c, and 2d - Others
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Client FG
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
Attachments 1a and 1b - Instruments
Attachments 1a and 1b - Instruments
Attachments 1a and 1b.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:
240
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
100 %
Requested
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
240
0
240
0
0
0
Annual IC Time Burden (Hours)
240
0
240
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachments 2a, 2b, 2c, and 2d - Others
Attachments 2a, 2b, 2c, and 2d.pdf
08/02/2010
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.