Application Packets for Real Property for Public Health Purposes

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0937-0191 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Application Packets for Real Property for Public Health Purposes	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 40 CFR 1500-1508 45 CFR 12-12a (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	20	-2	22
Annual IC Time Burden (Hours)	4,000	-400	4,400
Annual IC Cost Burden (Dollars)	3,600	3,600	0

Documents for IC

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