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Annual Program Performance Report
Protection and Advoccy of Individuals With Mental Illness (PAIMI) Annual Program Performance Report
OMB: 0930-0169
IC ID: 7549
OMB.report
HHS/SAMHSA
OMB 0930-0169
ICR 201105-0930-004
IC 7549
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0169 can be found here:
2023-06-23 - Revision of a currently approved collection
2020-04-02 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form Attachment B1 FY 2
Annual Program Performance Report
Form and Instruction
Attachment B1 FY 2 Attachment B1 FY 2011
Attachment B1 FY 2011 - 2014 8.12.11-FINAL.doc
Form and Instruction
Attachment A PAIMI PPR mailing letter 4.8.11.docx
Attachment A PAIMI PPR mailing letter
IC Document
Attachment C Comment.pdf
Attachment C Comment
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Annual Program Performance Report
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
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
Attachment B1 FY 2011
Attachment B1 FY 2011
Attachment B1 FY 2011 - 2014 8.12.11-FINAL.doc
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:
57
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
57
0
57
0
0
0
Annual IC Time Burden (Hours)
1,482
0
1,482
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachment A PAIMI PPR mailing letter
Attachment A PAIMI PPR mailing letter 4.8.11.docx
04/26/2011
Attachment C Comment
Attachment C Comment.pdf
04/15/2011
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.