OMB
.report
Search
Supplemental Youth & Young Adult Interview
Now Is the Time (NITT) - Healthy Transition (HT) Evaluation
OMB: 0930-0360
IC ID: 219894
OMB.report
HHS/SAMHSA
OMB 0930-0360
ICR 201601-0930-004
IC 219894
( )
Documents and Forms
Document Name
Document Type
Form MMP
Supplemental Youth & Young Adult Interview
Form and Instruction
MMP MMP
Attachment 8_Multi Media Probes.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Supplemental Youth & Young Adult Interview
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
MMP
MMP
Attachment 8_Multi Media Probes.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:
FR Citation:
Number of Respondents:
1,530
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
1,530
0
1,530
0
0
0
Annual IC Time Burden (Hours)
1,025
0
1,025
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.