This information
collection is approved through 2-99 under the following condition:
As agreed to by HHS, the Department will add a cover memorandum to
the consent form which contains the OMB number, burden estimate and
other statements required by the Paperwork Reduction Act of
1995.
Inventory as of this Action
Requested
Previously Approved
05/31/1999
05/31/1999
04/30/1996
50,000
0
40,000
50,000
0
50,000
0
0
0
These regulations and informed consent
procedures are associated with federally funded sterilization
services. Selected consent forms are audited during site visits and
program reviews by Federal program staff to ensure compliance with
the regulations and the protection of individual's rights.
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.