[Federal Register Volume 69, Number 68 (Thursday, April 8, 2004)]
[Notices]
[Page 18575]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-7927]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Office of the Secretary

[Document Identifier: OS-0990-0243]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Office of the Secretary, HHS.

    In compliance with the requirement of section 3506(c)(2)(A) of the 
Paperwork Reduction Act of 1995, the Office of the Secretary (OS), 
Department of Health and Human Services, is publishing the following 
summary of proposed collections for public comment. Interested persons 
are invited to send comments regarding this burden estimate or any 
other aspect of this collection of information, including any of the 
following subjects: (1) The necessity and utility of the proposed 
information collection for the proper performance of the agency's 
functions; (2) the accuracy of the estimated burden; (3) ways to 
enhance the quality, utility, and clarity of the information to be 
collected; and (4) the use of automated collection techniques or other 
forms of information technology to minimize the information collection 
burden.
    Type of Information Collection Request: Revision of a Currently 
Approved Collection.
    Title of Information Collection: OCR Pre-grant Data Request 
Package.
    Form/OMB No.: OS-0990-0243.
    Use: Health care providers who have requested certification to 
participate in the Medicare program must review their policies/
practices and submit documents to demonstrate compliance with the civil 
rights requirements of Title VI of the Civil Rights Act of 1964, 
Section 504 of the Rehabilitation Act of 1973 and the Age 
Discrimination Act of 1975.
    Frequency: Recordkeeping, Single time.
    Affected Public: Business or other for profit; state, local or 
tribal government.
    Annual Number of Respondents: 4,000.
    Total Annual Responses: 4,000.
    Average Burden Per Response: 16 hours.
    Total Annual Hours: 64,000.
    To obtain copies of the supporting statement and any related forms 
for the proposed paperwork collections referenced above, access the HHS 
Web site address at http://www.hhs.gov/oirm/ infocollect/pending/ or e-
mail your request, including your address, phone number, OMB number, 
and OS document identifier, to [email protected], or call the Reports 
Clearance Office on (202) 690-6162. Written comments and 
recommendations for the proposed information collections must be mailed 
within 30 days of this notice directly to the OMB Desk Officer at the 
address below: OMB Desk Officer: Brenda Aguilar, OMB Human Resources 
and Housing Branch, Attention: (OMB 0990-0243), New Executive 
Office Building, Room 10235, Washington, DC 20503.

    Dated: March 30, 2004.
Robert E. Polson,
Office of the Secretary, Paperwork Reduction Act Reports Clearance 
Officer.
[FR Doc. 04-7927 Filed 4-7-04; 8:45 am]
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