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View ICR - OIRA Conclusion

OMB Control No: 0930-0367	ICR Reference No: 201705-0930-001
Status: Historical Active	Previous ICR Reference No: 201701-0930-001
Agency/Subagency: HHS/SAMHSA	Agency Tracking No: 20358
Title: SAMHSA Checklist for SF-5161
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/27/2017
	Date Received in OIRA: 05/10/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2020	36 Months From Approved	06/30/2017
Responses	2,669	0	7,457
Time Burden (Hours)	801	0	19,930
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	2,669	7,457	-4,788
Annual Time Burden (Hours)	801	19,930	-19,129
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Currently there are 19,930 total burden hours in the OMB inventory. SAMHSA is requesting 801 hours. This program change of -19,129 hours is due to the following: CDC and HRSA no longer use the SF-5161 checklist form; and SAMHSA is only using the Checklist, not the Narrative.

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