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Program-Level Instrument
State Opioid Response (SOR) and Tribal Opioid Response (TOR) Program Data Collection and Performance Measurement
OMB: 0930-0384
IC ID: 234465
OMB.report
HHS/SAMHSA
OMB 0930-0384
ICR 202110-0930-002
IC 234465
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0384 can be found here:
2024-10-23 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form SOR_TOR Program Le
Program-Level Instrument
Form and Instruction
SOR_TOR Program Le SOR_TOR Program Level Tool
SOR_TOR Program Level Tool Revisions 5-13-21 clean.docx
Form and Instruction
SOR_TOR Program Le SOR_TOR Program Level Tool
SOR_TOR Program Level Tool Revisions 5-13-21 clean.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Program-Level Instrument
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
SOR_TOR Program Level Tool
SOR_TOR Program Level Tool
SOR_TOR Program Level Tool Revisions 5-13-21 clean.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:
Program-Level Instrument
FR Citation:
75 FR 28264
Number of Respondents:
159
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
636
0
-800
0
0
1,436
Annual IC Time Burden (Hours)
191
0
-53
0
0
244
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.