Recipient Information Instruments

[PHIC] Preventive Health and Health Services Block Grant

Att D_Recipient Information Instruments_050120

Recipient Information

OMB: 0920-0106

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-0106 can be found here:

2025-06-26 - No material or nonsubstantive change to a currently approved collection
2025-05-14 - No material or nonsubstantive change to a currently approved collection

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