42 C.F.R. Subpart B: Sterilization of Persons in Federally Assisted Family Planning Projects

ICR 202204-0937-001

OMB: 0937-0166

Federal Form Document

Forms and Documents
ICR Details
0937-0166 202204-0937-001
Received in OIRA 201810-0937-003
42 C.F.R. Subpart B: Sterilization of Persons in Federally Assisted Family Planning Projects
Reinstatement with change of a previously approved collection   No
Regular 05/09/2022
  Requested Previously Approved
36 Months From Approved
200,000 0
125,000 0
0 0

These regulations and informed consent procedures are associated with Federally funding sterilization services. Selected consent forms are audited during the site visits and program reviews by Federal programs to ensure compliance with the regulations and protection of individual's rights.

PL: Pub.L. 42 - 241 301 Name of Law: Public Health Service Act

Not associated with rulemaking

  87 FR 8594 02/15/2022
87 FR 27651 05/09/2022

IC Title Form No. Form Name
Information disclosure for sterilization consent forms
Record-keeping for Sterilization Consent Form 0937-0166 Sterilization Consent Form

  Total Request 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 200,000 0 0 0 0 200,000
Annual Time Burden (Hours) 125,000 0 0 0 0 125,000
Annual Cost Burden (Dollars) 0 0 0 0 0 0

Alicia Richmond Scott 240 453-2816 [email protected]


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.

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