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Federal forms, ICRs, and supporting documents

Information Collection Request

PREVENTIVE HEALTH AND HEALTH SERVICES BLOCK GRANT REPORTING REQUIREMENTS

ICR 198402-0920-004 · OMB 0920-0106 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
165699 PREVENTIVE HEALTH AND HEALTH SERVICES BLOCK GRANT REPORTING REQUIREMENTS Migrated
ICR Details
0920-0106 198402-0920-004
Historical Active 198308-0920-004
HHS/CDC
PREVENTIVE HEALTH AND HEALTH SERVICES BLOCK GRANT REPORTING REQUIREMENTS
No material or nonsubstantive change to a currently approved collection   No
Emergency 02/21/1984
Approved with change 02/21/1984
Retrieve Notice of Action (NOA) 02/21/1984
  Inventory as of this Action Requested Previously Approved
09/30/1985 09/30/1985 09/30/1985
114 0 57
17,580 0 17,580
0 0 0
TO COLLECT ANNUAL APPLICATION FOR FUNDING FROM 57 PUBLIC GRANTEES, AND TO COLLECT ANNUAL REPORT ON USE OF FUNDS FOR PREVENTIVE HEALTH AND HEALTH SERVICES BLOCK GRANT.
None
None
No
1
IC Title Form No. Form Name
PREVENTIVE HEALTH AND HEALTH SERVICES BLOCK GRANT REPORTING REQUIREMENTS
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 114 57 0 57 0 0
Annual Time Burden (Hours) 17,580 17,580 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
02/21/1984