PROJECT PROPOSAL FOR PROVISION OF SANITATION FACILITIES (P.L. 86-121)

ICR 198704-0915-003

OMB: 0915-0018

Federal Form Document

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Document
Name
Status
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ICR Details
0915-0018 198704-0915-003
Historical Active 198504-0915-002
HHS/HSA
PROJECT PROPOSAL FOR PROVISION OF SANITATION FACILITIES (P.L. 86-121)
Extension without change of a currently approved collection   No
Regular
Approved without change 06/26/1987
Retrieve Notice of Action (NOA) 04/23/1987
THIS INFORMATION COLLECTION RESQUEST IS APPROVED CONTINGENT ON THE AGREED UPON REVISIONS BEING MADED IN THE PRINTED FORM. IF THIS FORM BECOMES INCONSISTENT WITH IHS' FY88 BUDGET, IHS SHOULD RESUBMIT THIS FORM FOR CLEARANCE WITH APPROPRIATE REVISIONS TO ADDRESS THE INCONSISTENCIES.
  Inventory as of this Action Requested Previously Approved
06/30/1990 06/30/1990 07/31/1987
500 0 500
500 0 500
0 0 0

FORM HRSA-62 SOLICITS INFORMATION FROM TRIBES REGARDING THEIR NEEDS FOR SANITATION FACILITIES, THEIR WILLINGNESS AND/OR ABILITY TO OPERATE AND MAINTAIN THE NEEDED SANITATION FACILITIES, THEIR ABILITY AND WILLINGNESS TO CONTRIBUTE FUNDS/LABOR TO THE NEEDED SANITATION FACILITIES, SOURCE OF OUTSIDE FUNDING, THEIR DESIRE TO DEVELOP ORDINANCES/REGULATIONS DEALING WITH PUBLIC HEALTH.

None
None


No

1
IC Title Form No. Form Name
PROJECT PROPOSAL FOR PROVISION OF SANITATION FACILITIES (P.L. 86-121) HSA-62

  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 500 500 0 0 0 0
Annual Time Burden (Hours) 500 500 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
04/23/1987


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