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51.25(b)(3)
Protection and Advocacy for Individuals with Mental Illness Regulations -- 45 CFR Part 51
OMB: 0930-0172
IC ID: 192380
OMB.report
HHS/SAMHSA
OMB 0930-0172
ICR 201606-0930-001
IC 192380
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0172 can be found here:
2022-07-18 - Extension without change of a currently approved collection
2019-08-13 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form Statement
51.25(b)(3)
Form
Statement Statement
There are no instruments to this data collection.doc
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
51.25(b)(3)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Mandatory
CFR Citation:
42 CFR 51.PAIMI
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
Statement
Statement
There are no instruments to this data collection.doc
No
No
Paper Only
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:
57
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
45 %
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
57
0
0
0
0
57
Annual IC Time Burden (Hours)
29
0
0
0
0
29
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.