Project Evaluators - Campus

Cross-Site Evaluation of the Garrett Lee Smith Memorial Suicide Prevention and Early Intervention Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0286 can be found here:

Documents and Forms

Document Name Document Type
Form PSI Campus Project Evaluators - Campus Form and Instruction
PSI Campus PSI Campus Att C.2 PSI Campus Dec2015.docx Form and Instruction
TASP Campus TASP Campus Att D.2 TASP Campus Dec2015.docx Form and Instruction
SBHF Data Abstract SBHF Data Abstraction Campus Att I. SBHF Data Abstraction (Campus) Dec2015.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Project Evaluators - Campus	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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	PSI Campus	PSI Campus	Att C.2 PSI Campus Dec2015.docx	Yes	Yes	Fillable Fileable
Form and Instruction	TASP Campus	TASP Campus	Att D.2 TASP Campus Dec2015.docx	Yes	Yes	Fillable Fileable
Form and Instruction	SBHF Data Abstraction Campus	SBHF Data Abstraction Campus	Att I. SBHF Data Abstraction (Campus) Dec2015.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 56	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 Agency Discretion	Previously Approved
Annual Number of Responses for this IC	504	-216	720
Annual IC Time Burden (Hours)	261	-19	280
Annual IC Cost Burden (Dollars)	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.