[Federal Register Volume 60, Number 169 (Thursday, August 31, 1995)]
[Notices]
[Page 45488]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-21625]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Public Health Service


Agency Forms Undergoing Paperwork Reduction Act Review

    Periodically, the Public Health Service (PHS) publishes a list of 
information collection requests under review,in compliance with the 
Paperwork Reduction Act (44 U.S.C. Chapter 35). To request a copy of 
these requests, call the PHS Reports Clearance Office on (202) 690-
7100.
    The following request has been submitted for review since the list 
was last published on Friday, August 25.
    1. A Study of the Dissemination of the Maternal and Child 
Assistance Programs Model Application Form--New--A telephone survey 
will be conducted of representatives of governors' offices and state 
and local-level maternal and child assistance programs. The survey will 
provide data on the dissemination, use, and impact of the Model 
Application Form, a consolidated application form developed for use by 
maternal and child assistance programs.

------------------------------------------------------------------------
                                                                 Average
                                                     Number of   burden 
                Title                   Number of    responses     per  
                                       respondents      per     response
                                                    respondent   (hours)
------------------------------------------------------------------------
Survey of Governors' Offices.........          59           1         .5
Survey of State Programs.............         236           1         .5
Survey of Local Programs.............          50           1         .5
------------------------------------------------------------------------

Estimated Total Annual Burden: 173 hours.

    Written comments and recommendations concerning the proposed 
information collections should be sent within 30 days of this notice 
to: Allison Eydt, Human Resources and Housing Branch, Office of 
Management and Budget, New Executive Office Building, Room 10235, 
Washington, D.C. 20503.

    Dated: August 28, 1995.
James Scanlon,
Director, Data Policy Staff, Office of the Assistant Secretary for 
Health and PHS Reports Clearance Officer.
[FR Doc. 95-21625 Filed 8-30-95; 8:45 am]
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