Information Collection

[PHIC] PHHS Block Grant and PHIG Listening Sessions (2024)

IC 270197 under ICR 202505-0920-006 · OMB 0920-1050.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1050 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1050 [PHIC] PHHS Block Grant and PHIG Listening Sessions (2024)	Form and Instruction
Form 0920-1050 Guiding Questions for the PHHS Block Grant and PHIG Listening Session [PHIC] PHHS Block Grant and PHIG Listening Sessions (2024)	Form and Instruction
0920-1050 Guiding Questions for the PHHS Block Grant and PHIG List Att A_PHHSBG PHIG Questions.docx	Form and Instruction
0920-1050 Guiding Questions for the PHHS Block Grant and PHIG List Att A_PHHSBG PHIG Questions.docx	Form and Instruction
0920-1050_PHIC_Listening Sessions 2024 08 16.docx 0920-1050 GenIC Request Template	IC Document
0920-1050_PHIC_Listening Sessions 2024 08 16.docx 0920-1050 GenIC Request Template	IC Document

IC Title:

[PHIC] PHHS Block Grant and PHIG Listening Sessions (2024)

Agency IC Tracking Number:

0920-1050

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-1050			N/A	No		Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 58

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	58	58
Annual IC Time Burden (Hours)	87	87
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
0920-1050 GenIC Request Template		08/16/2024

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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