CSAP Client-Level Data

Common Data Platform

Documents and Forms

Document Name Document Type
Form CSAP Youth CSAP Client-Level Data Form and Instruction
CSAP Youth CSAP Youth Attachment 4 Final CSAP Youth 1.12.15.docx Form and Instruction
CSAP Adult CSAP Adult Attachment 5 Final CSAP Adult 1.12.15.doc Form and Instruction
Attachment 9 CDP_Reference_Guide_CSAP 11 19.docx Reference_Guide_CSAP IC Document

Information Collection (IC) Details

IC Title:	CSAP Client-Level Data	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	CSAP Youth	CSAP Youth	Attachment 4 Final CSAP Youth 1.12.15.docx		Yes	Yes	Fillable Fileable
Form and Instruction	CSAP Adult	CSAP Adult	Attachment 5 Final CSAP Adult 1.12.15.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 19,334	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	49,108	49,108
Annual IC Time Burden (Hours)	18,661	18,661
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Reference_Guide_CSAP	Attachment 9 CDP_Reference_Guide_CSAP 11 19.docx	12/19/2014

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