This information
collection request is being given an abbreviated clearance period
of 6 months, as agreed by HHS in its 11/15/2002 e-mail memo. During
the approval period, HHS will: (1) Ensure that this collection
conforms with the recently issued Medical Privacy regulation, (2)
Revise the consent form consistent with OMB standards on the
collection of race/ethnicity data (3) Revise form/instructions to
provide respondents with the PRA burden statement and (4) Update
HHS' approach to estimating the number of respondents for item 12
of the supporting statement.
Inventory as of this Action
Requested
Previously Approved
08/31/2003
08/31/2003
50,000
0
0
50,000
0
0
0
0
0
These regulations and informed consent
procedures are associated with Federally funded sterilization
services. Selected consent forms are audited during site visits by
Federal programs to ensure compliance with regulations and
protection of individuals' 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.