Application Packets for Real Property for Public Health Purposes

Forms and Documents

Document Name	Status
Justification for 0937-0191.docx Justification for No Material/Nonsubstantive Change	2019-06-19
0937-0191 HHS Title V application 6.2019 (003).pdf Supplementary Document	2019-06-19
Federal Register, Volume 83 Issue 27 (Thursday, February 8, 2018).html Supplementary Document	2018-02-09
60-day Federal Register, Volume 82 Issue 219 (Wednesday, November 15, 2017).htm Supplementary Document	2018-01-31

IC Document Collections

IC ID	Document Title	Status
7743	Application Packets for Real Property for Public Health Purposes Other-application	Unchanged

ICR Details

OMB Control No: 0937-0191	ICR Reference No: 201906-0937-003
Status: Active	Previous ICR Reference No: 201906-0937-002
Agency/Subagency: HHS/OASH	Agency Tracking No: 20215
Title: Application Packets for Real Property for Public Health Purposes
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/19/2019
	Date Received in OIRA: 06/19/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2021	04/30/2021	04/30/2021
Responses	15	0	15
Time Burden (Hours)	3,000	0	3,000
Cost Burden (Dollars)	1,125	0	1,125

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Abstract: State and local governments and nonprofit institutions use these applications to apply for excess/surplus, underutilized/unutilized and off-site government real property. These applications are used to determine if institutions/organizations are eligible to purchase, lease or use prop. under the provisions of surplus property program.

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Authorizing Statute(s): PL: Pub.L. 114 - 287 11 Name of Law: Federal Asset and Transfer Act of 2016
   US Code: 42 USC 4321-4370a Name of Law: The National Evironmental Policy Act
   PL: Pub.L. 100 - 77 501 Name of Law: Stewart B. McKinney-Vento Homeless Assistance Act
   PL: Pub.L. 81 - 152 203 Name of Law: The Federal Property and Administrative
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 52934	11/15/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 5634	02/08/2018
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Application Packets for Real Property for Public Health Purposes

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ICR Summary of Burden

	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	15	15	0	0	0	0
Annual Time Burden (Hours)	3,000	3,000	0	0	0	0
Annual Cost Burden (Dollars)	1,125	1,125	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $35,250

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 06/19/2019

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