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Sustainability Interviews
National Evaluation of SAMHSA's Youth Programs
OMB: 0930-0366
IC ID: 222117
OMB.report
HHS/SAMHSA
OMB 0930-0366
ICR 201606-0930-004
IC 222117
( )
Documents and Forms
Document Name
Document Type
Form Sustainability Int
Sustainability Interviews
Form and Instruction
Sustainability Int Sustainability Interview Guides
Attachment 3 Sustainability Interview Guides.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Sustainability Interviews
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
Sustainability Interview Guides
Sustainability Interview Guides
Attachment 3 Sustainability Interview Guides.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:
98
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
98
0
98
0
0
0
Annual IC Time Burden (Hours)
98
0
98
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.