OMB
.report
Search
Application Packets for Real Property for Public Health Purposes
Application Packets for Real Property for Public Health Purposes
OMB: 0937-0191
IC ID: 7743
OMB.report
HHS/OASH
OMB 0937-0191
ICR 201310-0937-001
IC 7743
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0937-0191 can be found here:
2024-10-25 - Reinstatement without change of a previously approved collection
2021-04-29 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
20215 ID-0937-0191 Title V application Oct.2013.doc
Other-application
20215 ID-0937-0191 Public Health Application Oct 2013.doc
Other-application
20215 ID-0937-191 Title V underutilized application Oct 2013.doc
Other-application
20215 ID-0937-0191 Off Site application Oct 2013.doc
Other-application
Information Collection (IC) Details
View Information Collection (IC)
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
Other-application
20215 ID-0937-0191 Title V application Oct.2013.doc
No
No
Printable Only
Other-application
20215 ID-0937-0191 Public Health Application Oct 2013.doc
No
No
Printable Only
Other-application
20215 ID-0937-191 Title V underutilized application Oct 2013.doc
No
No
Printable Only
Other-application
20215 ID-0937-0191 Off Site application Oct 2013.doc
No
No
Printable Only
Federal Enterprise Architecture Business Reference Module
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 New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
20
0
20
0
0
0
Annual IC Time Burden (Hours)
4,000
0
4,000
0
0
0
Annual IC Cost Burden (Dollars)
3,600
0
3,600
0
0
0
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.