Information Collection Request

Application Packets for Real Property for Public Health Purposes

ICR 202412-0937-002 · OMB 0937-0191 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
0937-0191 HHS Title V application 12.6.24 TR revised (002).pdf Justification for No Material/Nonsubstantive Change Uploaded 2024-12-13 Repair queued
0937-0191 HHS Title V application 12.6.24 TR revised (002).pdf Justification for No Material/Nonsubstantive Change Uploaded 2024-12-13 Repair queued
OMB Memo #0937-0191 12.11.24.pdf Supplementary Document Uploaded 2024-12-13 Repair queued
OMB Memo #0937-0191 12.11.24.pdf Supplementary Document Uploaded 2024-12-13 Repair queued
Final 0937-0191 Supporting_ST _A 5.1.2024.docx Supporting Statement A Uploaded 2024-10-25 Available
Final 0937-0191 Supporting_ST _A 5.1.2024.docx Supporting Statement A Uploaded 2024-10-25 Repair queued
HHS Public Health Application 11.17.21.pdf Supplementary Document Uploaded 2024-08-14 Repair queued
HHS Public Health Application 11.17.21.pdf Supplementary Document Uploaded 2024-08-14 Missing upstream
60 Day FR Notice.pdf Supplementary Document Uploaded 2024-08-14 Repair queued
60 Day FR Notice.pdf Supplementary Document Uploaded 2024-08-14 Repair queued
0937-0191 HHS Title V application 6.2019 (003).pdf Supplementary Document Uploaded 2019-06-19 Repair queued
0937-0191 HHS Title V application 6.2019 (003).pdf Supplementary Document Uploaded 2019-06-19 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
7743 Application Packets for Real Property for Public Health Purposes Other-Application Unchanged

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2027 12/31/2027 12/31/2027
10 0 10
2,000 0 2,000
2,500 0 2,500





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Application Packets for Real Property for Public Health Purposes

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 10 10 0 0 0 0
Annual Time Burden (Hours) 2,000 2,000 0 0 0 0
Annual Cost Burden (Dollars) 2,500 2,500 0 0 0 0


Reginfo record details
  No