Information Collection

42 Cfr 2.22

IC 7502 under ICR 201307-0930-001 · OMB 0930-0092.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0092 can be found here:

Documents and Forms

Document Name Document Type
SAMHSAHIPAAComparisonClearedPDFVersion.pdf Other-Regulation and HIPAA Rule

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	42 CFR 2.22	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Regulation and HIPAA Rule			SAMHSAHIPAAComparisonClearedPDFVersion.pdf		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 11,724	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,994,632	129,129	1,865,503
Annual IC Time Burden (Hours)	398,872	25,771	373,101
Annual IC Cost Burden (Dollars)	92,477	0	92,477

Documents for IC

Title	Document	Date Uploaded
No associated records found

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