Information Collection Request
State Office of Rural Health Grant Technical Assistance
ICR 202303-0915-002 · OMB 0915-0322 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0915-0322 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form 1 State Offices of Rural Health TA Data Collection Form |
Form and Instruction | Modified | Repair queued |
 SORH PIMS Example.pdf |
Supplementary Document | Uploaded 2023-03-17 | Repair queued |
 SORH 30 Day FRN Supporting Statement FINAL 03032023 500.docx |
Supporting Statement A | Uploaded 2023-03-17 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 186810 |  State Offices of Rural Health TA Data Collection Form |
Form and Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/HSA |
| OMB Control No | 0915-0322 |
| Type of Information Collection | Extension without change of a currently approved collection |
| Previous ICR Reference No | 201912-0915-002 |
| Agency Tracking No | 19868 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |