Application Packets for Real Property for Public Health Purposes

ICR 200412-0937-001

OMB: 0937-0191

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0937-0191 200412-0937-001
Historical Active 200104-0937-001
HHS/OASH
Application Packets for Real Property for Public Health Purposes
Reinstatement without change of a previously approved collection   No
Regular
Approved without change 02/03/2005
Retrieve Notice of Action (NOA) 12/17/2004
Approved consistent with the following terms: HHS is reminded to request extensions for ongoing collections from OMB prior to expiration.
  Inventory as of this Action Requested Previously Approved
02/29/2008 02/29/2008
22 0 0
4,400 0 0
0 0 0

State and local governments and nonprofit institutions use these applications to apply for excess/surplus, underutilized/ unutilized and off-site government real property. These applications are used to determine if institutions/organizations are eligible to purchase, lease or use prop. under the provisions of surplus property program.

None
None


No

1
IC Title Form No. Form Name
Application Packets for Real Property for Public Health Purposes HHS-696

  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 22 0 0 22 0 0
Annual Time Burden (Hours) 4,400 0 0 4,400 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
12/17/2004


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