OMB
.report
Search
Annual Census of Patient Characteristics in State and County Mental Hospital Inpatient Services
Annual Census of Patient Characteristics in State and County Mental Hospital Inpatient Services
OMB: 0930-0093
IC ID: 7504
OMB.report
HHS/SAMHSA
OMB 0930-0093
ICR 200008-0930-002
IC 7504
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0093 can be found here:
2003-09-11 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Annual Census of Patient Characteristics in State and County Mental Hospital Inpatient Services
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Migrated
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
SMA-102
Yes
Yes
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
52
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
42 %
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
52
0
0
-6
0
58
Annual IC Time Burden (Hours)
104
0
0
-12
0
116
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.