Federal Set-Aside Program of the Maternal and Child Health Services Block Grant Program - 42 CFR 51a.4

ICR 199604-0915-001

OMB: 0915-0050

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
0915-0050 199604-0915-001
Historical Active 199303-0915-001
HHS/HSA
Federal Set-Aside Program of the Maternal and Child Health Services Block Grant Program - 42 CFR 51a.4
Extension without change of a currently approved collection   No
Regular
Approved without change 05/15/1996
Retrieve Notice of Action (NOA) 04/10/1996
  Inventory as of this Action Requested Previously Approved
05/31/1999 05/31/1999 05/31/1996
1 0 1
1 0 1
0 0 0

This request is for renewal of the OMB approval for the information (42 CFR 51a.4) for applications for the Federal Set-Aside program of the Maternal and Child Health Services Block Grant.

None
None


No

1
IC Title Form No. Form Name
Federal Set-Aside Program of the Maternal and Child Health Services Block Grant Program - 42 CFR 51a.4

  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 1 1 0 0 0 0
Annual Time Burden (Hours) 1 1 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.
04/10/1996


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