NIMH and NIMHD Virtual Workshop on Mental Health Disparities Registration (State and local) (NIMH)

Conference, Meeting, Workshop, and Poster Session Registration Generic Clearance (OD)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0740 can be found here:

Documents and Forms

Document Name Document Type
Form 1 NIMH and NIMHD Virtual Workshop on Mental Health Disparities Registration (State and local) (NIMH) Form
1 NIMH and NIMHD Virtual Workshop Registration form NIHM and NIMHD Virtual Workshop Registration Form.docx Form
NIH Generic 0740 Template_NIMH and NIMHD Disparities Workshop Registration (StateLocal).docx NIMH and NIMHD Virtual Disparities Workshop IC Document

Information Collection (IC) Details

IC Title:	NIMH and NIMHD Virtual Workshop on Mental Health Disparities Registration (State and local) (NIMH)	Agency IC Tracking Number:

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	1	NIMH and NIMHD Virtual Workshop Registration form	NIHM and NIMHD Virtual Workshop Registration Form.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	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 Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	1	1
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
NIMH and NIMHD Virtual Disparities Workshop	NIH Generic 0740 Template_NIMH and NIMHD Disparities Workshop Registration (StateLocal).docx	10/07/2020

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.