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Tribal Cooperative Agreements
988 Cooperative Agreements Monitoring Program
OMB: 0930-0394
IC ID: 260135
OMB.report
HHS/SAMHSA
OMB 0930-0394
ICR 202305-0930-001
IC 260135
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0394 can be found here:
2023-12-15 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form Tribal Govt: Semi
Tribal Cooperative Agreements
Form and Instruction
Form Tribal Govt: Semi
Tribal Cooperative Agreements
Form and Instruction
Tribal Govt: Semi Tribal Govt: Semi Annual Progress Report
988 Tribal Instrument 1 _ Semi-annual Reports 4.5.23.docx
Form and Instruction
Tribal Govt: Semi Tribal Govt: Semi Annual Progress Report
988 Tribal Instrument 1 _ Semi-annual Reports 4.5.23.docx
Form and Instruction
Tribal Govt: Month Tribal Govt: Monthly Meeting Agenda
988 Tribal Instrument 2 _ Monthly Agenda 4.5.23.docx
Form and Instruction
Tribal Govt: Month Tribal Govt: Monthly Meeting Agenda
988 Tribal Instrument 2 _ Monthly Agenda 4.5.23.docx
Form and Instruction
Tribal Govt: Quali Tribal Govt: Quality Improvement Plan
988 Tribal Instrument 3 _ Quality Improvement Plan 4.5.23.docx
Form and Instruction
Tribal Govt: Quali Tribal Govt: Quality Improvement Plan
988 Tribal Instrument 3 _ Quality Improvement Plan 4.5.23.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Tribal Cooperative Agreements
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
Tribal Govt: Semi Annual Progress Report
Tribal Govt: Semi Annual Progress Report
988 Tribal Instrument 1 _ Semi-annual Reports 4.5.23.docx
Yes
Yes
Fillable Fileable
Form and Instruction
Tribal Govt: Monthly Meeting Agenda
Tribal Govt: Monthly Meeting Agenda
988 Tribal Instrument 2 _ Monthly Agenda 4.5.23.docx
Yes
Yes
Fillable Fileable
Form and Instruction
Tribal Govt: Quality Improvement Plan
Tribal Govt: Quality Improvement Plan
988 Tribal Instrument 3 _ Quality Improvement Plan 4.5.23.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
Privacy Act of 1974 (Title 5 United States Code [U.S.C.] 552a)
FR Citation:
75 FR 28264
Number of Respondents:
375
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
375
0
375
0
0
0
Annual IC Time Burden (Hours)
450
0
450
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.