Information Collection

State of the States in Services and Supports for ASD: Data Collection and Verification Tool

IC 198119 under ICR 201106-0938-012 · OMB 0938-1142.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1142 can be found here:

Documents and Forms

Document Name Document Type
Data Collection Tool [rev 06-13-11].doc Other-Interview: Data Collection and
2011 IACC Strategic Plan for ASD Research.pdf 2011 IACC Strategic Plan IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	State of the States in Services and Supports for ASD: Data Collection and Verification Tool	Agency IC Tracking Number:

Is this a Common Form? No		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
Other-Interview: Data Collection and Verification Tool			Data Collection Tool [rev 06-13-11].doc		No	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 51	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	459	459
Annual IC Time Burden (Hours)	1,377	1,377
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
2011 IACC Strategic Plan	2011 IACC Strategic Plan for ASD Research.pdf	06/14/2011

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