View Information Collection (IC)
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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Drug and Alcohol Services Information System
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
Attachment B2
2007 Questionnaire
OMB Att-B2 2007 Questionnaire.pdf
Yes
Yes
Paper Only
Form and Instruction
Attachment B1
Mark-up 2006
OMB Att-B1 Markup 2006 Questionnaire.pdf
Yes
Yes
Paper Only
Form and Instruction
Attachment B4
2007 CATI Questionnaire
OMB Att B4 CATI.pdf
Yes
Yes
Paper Only
Form and Instruction
Attachment B5
Mini 2007 CATI Questionnaire
OMB Att B5 Mini CATI.pdf
Yes
Yes
Paper Only
Form and Instruction
Attachment B3
2007 Web Screen On-line Questionnaire
Attachment B-3 Combined..zip
Yes
Yes
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
18,856
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
0 %
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
22,816
0
-109
-200
0
23,125
Annual IC Time Burden (Hours)
14,640
0
-10
8,159
0
6,491
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachment B6 - 2007 Advance Letter
OMB Att B6 AdvanceLtr_20071.pdf
08/09/2006
Attachment A
Attachment A.zip
08/09/2006
Terms of Clearance Memo
terms memo.wpd
08/09/2006
Attachment B7 - 2007 Cover Letter
OMB Att B7 CoverLtr1stWebFlyFAQ_20071.pdf
08/09/2006
Attachment B8 - 2007 Thank You Letter
OMB Att B8 TkYou-ReminderLtr_20071.pdf
08/09/2006
Attachment B9 - 2007 2nd Cover Letter
OMB Att B9 2ndQuexCoverLtr_2007.pdf
08/09/2006
Attachment B10 - 2007 Mini Advance Letter
OMB Att B10 - MiniAdvanceLtr.pdf
08/09/2006
Attachment B11 - Info Website
OMB Att-B11 2007 Info Website.pdf
08/09/2006
Attachment C1 - 60-Day FR Notice
Attachment C1 - 60-day FR notice .pdf
08/09/2006
Attachment C2 - Pretest Respondents
OMB Att C2 List of Pretest Respondents.pdf
08/09/2006
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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