[PHIC] Preventive Health and Health Services Block Grant

ICR 202401-0920-007

OMB: 0920-0106

Federal Form Document

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0920-0106 can be found here:

2025-06-26 - No material or nonsubstantive change to a currently approved collection
2025-05-14 - No material or nonsubstantive change to a currently approved collection

Forms and Documents

Document Name	Status
Work Plan Instrument Form and Instruction	Removed
Annual Progress Report (subset of Final Progress questions) Form and Instruction	New
Annual Progress Report (subset of Interim Progress questions) Form and Instruction	New
Work Plan Program Questions Form and Instruction	New
Workplan Start and Advisory Committee Questions Form and Instruction	New
Recipient Information Form and Instruction	Removed
Annual Progress Report Instrument Form and Instruction	Removed
OCIO_Azure_GSS_AO_Decision_Letter_(High)_09152023.pdf Supplementary Document	2024-01-29
Copy_of_Privacy_Impact_Assessment_PIA_bl.pdf Supplementary Document	2024-01-29
Att N_BGIS_2023 OMB pkg Crosswalk of changes_011024.xlsx Supplementary Document	2024-01-29
Att M_Announcements on BGIS Landing Page_Screenshot.docx Supplementary Document	2024-01-29
Att L_STARS Project Determination.docx Supplementary Document	2024-01-29
Att K_Privacy Act Checklist_BGIS 2023.docx Supplementary Document	2024-01-29
Att I_0920-0106_60dayFRN_05012023.pdf Supplementary Document	2024-01-29
Statement B-Block Grant ICR_2023.docx Supporting Statement B	2024-01-29
Statement A-Block Grant ICR_2023_final.docx Supporting Statement A	2024-01-12
Att B_Block Grant Authorizing Legislation 1981 and 1992.docx Supplementary Document	2024-01-29
Att A_List of PHHS Block Grant Recipients.docx Supplementary Document	2024-01-29

IC Document Collections

IC ID	Document Title	Status
6636	Work Plan Instrument Form and Instruction	Removed
264761	Annual Progress Report (subset of Final Progress questions) Form and Instruction	New
264760	Annual Progress Report (subset of Interim Progress questions) Form and Instruction	New
264759	Work Plan Program Questions Form and Instruction	New
264758	Workplan Start and Advisory Committee Questions Form and Instruction	New
243520	Recipient Information Form and Instruction	Removed
184866	Annual Progress Report Instrument Form and Instruction	Removed

ICR Details

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