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Training Summary Form
Cross-Site Evaluation of the National Child Traumatic Stress Initiative (NCTSI)
OMB: 0930-0276
IC ID: 199508
OMB.report
HHS/SAMHSA
OMB 0930-0276
ICR 201109-0930-005
IC 199508
( )
Documents and Forms
Document Name
Document Type
Form Training Summary F
Training Summary Form
Form and Instruction
Training Summary F Training Summary Form
Attachment G_Training Summary Form.doc
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Training Summary Form
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
Training Summary Form
Training Summary Form
Attachment G_Training Summary Form.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:
124
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
248
0
248
0
0
0
Annual IC Time Burden (Hours)
50
0
50
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.