Information Collection Request
Maternal and Child Health Services Block Grant Application/Annual Report Guidance
ICR 202503-0915-002 · OMB 0915-0172 · Active
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form 1 Application/Annual Report with Needs Assessment Summary |
Form and Instruction | Modified | Available |
| Form 1 Application/Annual Report with Needs Assessment Summary |
Form and Instruction | Modified | Repair queued |
 1A_MCHB_0915-0172_MCHB_Table of Proposed Changes.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2025-03-26 | Available |
| 1A_MCHB_0915-0172_MCHB_Table of Proposed Changes.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2025-03-26 | Repair queued |
| 1_MCHB_0915-0172_OMB NonSubstantive Change Request.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2025-03-26 | Available |
| 1_MCHB_0915-0172_OMB NonSubstantive Change Request.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2025-03-26 | Repair queued |
| Final SSA 0172 Clean.docx |
Supporting Statement A | Uploaded 2023-09-28 | Available |
| Final SSA 0172 Clean.docx |
Supporting Statement A | Uploaded 2023-09-28 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 6398 |  Application/Annual Report with Needs Assessment Summary |
Form and Instruction | Modified | |
| 6398 | Application/Annual Report with Needs Assessment Summary |
Form and Instruction | Modified |
ICR Details
| Status | Active |
|---|---|
| Agency/Subagency | HHS/HSA |
| OMB Control No | 0915-0172 |
| Type of Information Collection | No material or nonsubstantive change to a currently approved collection |
| Previous ICR Reference No | 202309-0915-006 |
| Date Submitted to OIRA | 2025-03-28 |
| Requested Expiration Date | 1969-12-31 |