Agency Forms Submitted to the Office of Management and Budget for Clearance

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Office of the Secretary

Agency Forms Submitted to the Office of Management and Budget for

Clearance

On Fridays, the Department of Health and Human Services, Office of

the Secretary publishes a list of information collections it has

submitted to the Office of Management and Budget (OMB) for clearance in

compliance with the Paperwork Reduction Act (44 U.S.C. Chapter 35). The

following are those information collections recently submitted to OMB.

1. Hill-Burton Community Service Assurance Report--Extension with

No Change--0990-0096--The Community Service Assurance Report provides

information on community services provided by Hill-Burton recipients.

The Public Health Service Act (Titles VI and XVI) requires that this

information be obtained periodically to enable assessment of the

compliance of recipient Hill-Burton health facilities with their

community services assurances. Respondents: State or local governments,

non-profit institutions; Total Number of Respondents: 6,300; Frequency

of Response: once every three years; Average Burden per Response: 52.5

hours; Estimated Annual Burden: 110,250 hours.

OMB Desk Officer: Allison Eydt.

Copies of the information collection packages listed above can be

obtained by calling the OS Reports Clearance Officer on (202) 619-1053.

Written comments and recommendations for the proposed information

collection should be sent directly to the OMB desk officer designated

above at the following address: OMB Reports Management Branch, New

Executive Office Building, Room 3208, Washington, D.C. 20503.

Dated: March 21, 1995.

Dennis P. Williams,

Deputy Assistant Secretary, Budget.

[FR Doc. 95-7745 Filed 3-30-95; 8:45 am]

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