Indian Affairs Public Health Needs Assessment

ICR 202210-1076-002

OMB: 1076-0200

Federal Form Document

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1076-0200 can be found here:

2025-09-23 - Extension without change of a currently approved collection

Forms and Documents

Document Name	Status
Survey (Individuals) Form and Instruction	New
Survey (State, Local, Tribal Governments) Form and Instruction	New
88 FR 1607.pdf Supplementary Document	2023-01-11
Indian Affairs Public Health Needs Assessment_Supporting Statement B.docx Supporting Statement B	2022-11-14
IAFR001134__SSA_Public Health Needs Assessment (2022) - JP Feedback.docx Supporting Statement A	2022-11-14
87 FR 39546.pdf Supplementary Document	2022-10-07
Occupational Safety and Health Act of 1970 (PL).pdf Supplementary Document	2022-10-07
Occupational Safety and Health Act of 1970 (USC).pdf Supplementary Document	2022-10-07

IC Document Collections

IC ID	Document Title	Status
256326	Survey (Individuals) Form and Instruction	New
256325	Survey (State, Local, Tribal Governments) Form and Instruction	New

ICR Details

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