Application Packets for Real Property for Public Health Purposes

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
30-day Federal Register, Volume 81 Issue 235 (Wednesday, December 7, 2016).htm	Supplementary Document	Uploaded 2016-12-14	Available
60-day Federal Register, Volume 81 Issue 182 (Tuesday, September 20, 2016).htm	Supplementary Document	Uploaded 2016-12-14	Available
0937-0191 Supporting_ST _A Extension FY16.docx	Supporting Statement A	Uploaded 2016-12-15	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
7743	Application Packets for Real Property for Public Health Purposes	Other-application	Modified

ICR Details

OMB Control No: 0937-0191	ICR Reference No: 201611-0937-001
Status: Historical Active	Previous ICR Reference No: 201310-0937-001
Agency/Subagency: HHS/OASH	Agency Tracking No: 20215
Title: Application Packets for Real Property for Public Health Purposes
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/17/2017
	Date Received in OIRA: 12/15/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2020	36 Months From Approved	01/31/2017
Responses	15	0	20
Time Burden (Hours)	3,000	0	4,000
Cost Burden (Dollars)	1,125	0	3,600

---

Abstract: 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.

---

Authorizing Statute(s): PL: Pub.L. 100 - 77 501 Name of Law: Stewart B. McKinney-Vento Homeless Assistance Act
   US Code: 42 USC 4321-4370a Name of Law: The National Evironmental Policy Act
   PL: Pub.L. 81 - 152 203 Name of Law: The Federal Property and Administrative
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 64470	09/20/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 88246	12/02/2016
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Application Packets for Real Property for Public Health Purposes

---

ICR Summary of Burden

table that charts list of burden

	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	15	20	0	-5	0	0
Annual Time Burden (Hours)	3,000	4,000	0	-1,000	0	0
Annual Cost Burden (Dollars)	1,125	3,600	0	-2,475	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Using Information Technology

Short Statement: Due to an adjustment the burden hour changes – Decrease 1000 - 4000 burden hours equals a total of 3,000 burden hours, at 15 number respondents. Three years ago the total estimated number of respondents was 20, whereas today the estimate is 15 respondents; resulting in number of respondents decreasing by 5.

---

Annual Cost to Federal Government: $36,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 12/15/2016

---