OMB
.report
Search
Block Grant Application
Community MH Services BG and SAPT BG Application Guidance and Instructions FY 2022-2023
OMB: 0930-0168
IC ID: 7545
OMB.report
HHS/SAMHSA
OMB 0930-0168
ICR 202209-0930-006
IC 7545
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0168 can be found here:
2023-05-02 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form FFY 2022-2023 Bloc
Block Grant Application
Form and Instruction
FFY 2022-2023 Bloc FFY 2022-2023 Block Grant Application
FFY 2022-2023 Block Grant Application_ Clean 9.21.21_.docx
Form and Instruction
FFY 2022-2023 Bloc FFY 2022-2023 Block Grant Application
FFY 2022-2023 Block Grant Application_ Clean 9.21.21_.docx
Form and Instruction
OMB MHBG Report _ Clean 9.21.21_.docx
MHBG Report
IC Document
OMB MHBG Report _ Clean 9.21.21_.docx
MHBG Report
IC Document
OMB SABG Report _ Clean 9.21.21_.docx
SABG Report
IC Document
OMB SABG Report _ Clean 9.21.21_.docx
SABG Report
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Block Grant Application
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Required to Obtain or Retain Benefits
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
FFY 2022-2023 Block Grant Application
FFY 2022-2023 Block Grant Application
FFY 2022-2023 Block Grant Application_ Clean 9.21.21_.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
119
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
119
0
0
0
0
119
Annual IC Time Burden (Hours)
33,493
0
0
0
0
33,493
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
MHBG Report
OMB MHBG Report _ Clean 9.21.21_.docx
01/05/2022
SABG Report
OMB SABG Report _ Clean 9.21.21_.docx
01/05/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.