Application Packets for Real Property for Public Health Purposes

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
0937-0191 HHS Title V application 6.2019 (003).pdf	Justification for No Material/Nonsubstantive Change	Uploaded 2019-06-11	Available
Federal Register, Volume 83 Issue 27 (Thursday, February 8, 2018).html	Supplementary Document	Uploaded 2018-02-09	Available
60-day Federal Register, Volume 82 Issue 219 (Wednesday, November 15, 2017).htm	Supplementary Document	Uploaded 2018-01-31	Available
0937-0191 Supporting_ST _A Update-please (2).docx	Supporting Statement A	Uploaded 2018-03-14	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	Unchanged

ICR Details

OMB Control No: 0937-0191	ICR Reference No: 201906-0937-002
Status: Historical Inactive	Previous ICR Reference No: 201711-0937-001
Agency/Subagency: HHS/OASH	Agency Tracking No: 20215
Title: Application Packets for Real Property for Public Health Purposes
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Improperly submitted and continue	Conclusion Date: 06/13/2019
	Date Received in OIRA: 06/12/2019
Terms of Clearance: This non-substantive change request does not include a justification memo explaining what changes the agency is requesting and why. Please re-submit with this information.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2021	04/30/2021	04/30/2021
Responses	15	0	15
Time Burden (Hours)	3,000	0	3,000
Cost Burden (Dollars)	1,125	0	1,125

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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.

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Authorizing Statute(s): US Code: 42 USC 4321-4370a Name of Law: The National Evironmental Policy Act
   PL: Pub.L. 100 - 77 501 Name of Law: Stewart B. McKinney-Vento Homeless Assistance Act
   PL: Pub.L. 81 - 152 203 Name of Law: The Federal Property and Administrative
   PL: Pub.L. 114 - 287 11 Name of Law: Federal Asset and Transfer Act of 2016
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 52934	11/15/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 5634	02/08/2018
Did the Agency receive public comments on this ICR? No

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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

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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: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $35,250

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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

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Common Form ICR:  No

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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: 06/12/2019

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