View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	APPLICATION FOR GRANTS UNDER THE MENTAL HEALTH PERSONNEL TECHNICAL ASSISTANCE CENTER	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	N/A	N/A	1894-0006 Mental Health Personnel TA Center Application Package.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10	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	10	0	10	0	0	0
Annual IC Time Burden (Hours)	350	0	350	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
83C Justification Form	1894-0006 OMB 83 C Form MHP TA Center.pdf	04/13/2023
Standard Forms	1894-0006 Standard forms MHP TA Center.docx	04/13/2023

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