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IHS976 (10/2017)DEPARTMENT OF HEALTH AND HUMAN SERVICE Indian Health ServiceNow APPROVED: OMB NO. 09170040 Expiration Date: 06/30/2025 See OMB Statement on Page 3PURCHASED / REFERRED CARE PROOF OF
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The OMB statement is on the federal agency's information collection activities.
Federal agencies are required to file the OMB statement for their information collection activities.
The OMB statement can be filled out online through the OMB's website.
The purpose of the OMB statement is to provide transparency and accountability for federal agencies' information collection activities.
The OMB statement must include details on the agency's information collection activities, including the purpose, timeframe, and estimated burden on respondents.
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