Information Collection

Application Guidelines For Designation And Grant Award And Reporting System For Shpdas

IC 110176 under ICR 198306-0915-005 · OMB 0915-0058.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0058 can be found here:

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Information Collection (IC) Details

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IC Title:	APPLICATION GUIDELINES FOR DESIGNATION AND GRANT AWARD AND REPORTING SYSTEM FOR SHPDAS	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	PHS 5161,	No	No
Form	HRSA 281-1,	No	No
Form	281-2, &	No	No
Form	282	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 57	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
Annual Number of Responses for this IC	57	57
Annual IC Time Burden (Hours)	7,125	7,125
Annual IC Cost Burden (Dollars)	0	0

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