View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

SAMHSA 988 Media Campaign Evaluation Omnibus Survey
 
New
 
Voluntary
 
5 CFR 1320

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 988 Campaign Evaluation Survey 988 Campaign Evaluation Survey SAMHSA 988 Campaign Eval Survey 12Dec24 clean.docx Yes Yes Fillable Fileable
Form and Instruction Omnibus Survey Consent Process Omnibus Survey Consent Process Omnibus Survey Consent Process-PRA 12Dec24 clean.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

Privacy Act of 1974 (Title 5 United States Code [U.S.C.] 552a)   75 FR 28264

2,000 0
   
State, Local, and Tribal Governments
 
   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 6,000 0 6,000 0 0 0
Annual IC Time Burden (Hours) 500 0 500 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Request Template SAMHSA Research 988 Eval OMB package 12Dec24 clean.docx 12/31/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.