[Federal Register Volume 78, Number 212 (Friday, November 1, 2013)]
[Notices]
[Pages 65651-65652]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-26001]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

 Office of the Secretary

[Document Identifier HHS-OS-20358-30D]


Agency Information Collection Activities; Submission to OMB for 
Review and Approval; Public Comment Request

AGENCY: Office of the Secretary, HHS.

ACTION: Notice.

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SUMMARY: In compliance with section 3507(a)(1)(D) of the Paperwork 
Reduction Act of 1995, the Office of the Secretary (OS), Department of 
Health and Human Services, has submitted an Information Collection 
Request (ICR), described below, to the Office of Management and Budget 
(OMB) for review and approval. The ICR is for renewal of the approved 
information collection assigned OMB control number 0990-0317, scheduled 
to expire on October 31, 2013. Comments submitted during the first 
public review of this ICR will be provided to OMB. OMB will accept 
further comments from the public on this ICR during the review and 
approval period.

DATES: Comments on the ICR must be received on or before December 2, 
2013.

ADDRESSES: Submit your comments to [email protected] or via 
facsimile to (202) 395-5806.

FOR FURTHER INFORMATION CONTACT: Information Collection Clearance 
staff, [email protected] or (202) 690-6162.

SUPPLEMENTARY INFORMATION: When submitting comments or requesting 
information, please include the OMB control number 0990-0317 and 
document identifier HHS-OS-20358-30D for reference.
    Information Collection Request Title: HHS Supplemental Form to the 
SF-424 (HHS 5161-1).
    OMB No.: 0990-0317.
    Abstract: HHS is requesting clearance for use of the Checklist and 
Program Narrative, with non-substantial changes, & the Public Health 
System Impact Statement (PHSIS), used by the Substance Abuse and Mental 
Health Services Administration (SAMHSA) and several former PHS agencies 
within HHS; CDC 0.1113 supplemental forms used exclusively by CDC; a 
supplement form used exclusively by SAMHSA, and the Single Source 
Agency (SSA) notification form, as well as continued use of the project 
abstract form. In addition, SAMHSA will continue to include the HHS 
grant application checklist form.
    Need and Proposed Use of the Information: Each agency's financial 
assistance program evaluates the information provided by the applicants 
to select the ones most likely to meet program objectives and to 
determine that satisfactory progress is being made on funded projects.
    Likely Respondents: CDC, SAMHSA, IHS, OS, FDA, and HRSA.
    Burden Statement: Burden in this context means the time expended by 
persons to generate, maintain, retain, disclose or provide the 
information requested. This includes the time needed to review 
instructions, to develop, acquire, install and utilize technology and 
systems for the purpose of collecting, validating and verifying 
information, processing and maintaining information, and disclosing and 
providing information, to train personnel and to be able to respond to 
a collection of information, to search data sources, to complete and 
review the collection of information, and to transmit or otherwise 
disclose the information. The total annual burden hours estimated for 
this ICR are summarized in the table below.

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                                                                                  Average burden
                     Forms                          Number of      Response per    per response    Total burden
                                                   respondents      respondent      (in hours)      (in hours)
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Program Narrative, Checklist, & Project                   7,338              1                 4          29,373
 Abstract......................................
Program Narrative, Checklist & Project                       59              6                24           8,496
 Narrative (CDC)...............................
Program Narrative, Checklist, & Project                      59              1                50           2,950
 Narrative (HRSA)..............................
CDC Form 0.1113................................           1,000              1             30/60             500
Public Health Impact Statement (PHSIS).........           2,845              2.5           10/60           1,185
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    Total......................................  ..............  ...............  ..............          42,691
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[[Page 65652]]

Darius Taylor,
Deputy, Information Collection Clearance Officer.
[FR Doc. 2013-26001 Filed 10-31-13; 8:45 am]
BILLING CODE 4151-17-P