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Direct Service Staff
Targeted Capacity Expansion Program for Substance Abuse Treatment and HIV/AIDS Services (TCE-HIV)
OMB: 0930-0317
IC ID: 194044
OMB.report
HHS/SAMHSA
OMB 0930-0317
ICR 201010-0930-001
IC 194044
( )
Documents and Forms
Document Name
Document Type
Form Direct Service Sta
Direct Service Staff
Form and Instruction
Direct Service Sta Direct Service Staff Instruments
Attachment 5-Direct Service Staff Instruments.pdf
Form and Instruction
Attachment 6-Direct Services Other.pdf
Direct Service Staff Other
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Direct Service Staff
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
Direct Service Staff Instruments
Direct Service Staff Instruments
Attachment 5-Direct Service Staff Instruments.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:
144
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
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
288
0
288
0
0
0
Annual IC Time Burden (Hours)
288
0
288
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Direct Service Staff Other
Attachment 6-Direct Services Other.pdf
10/20/2010
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.