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     Indian Health Manual

Exhibit 8-101-G

IHS Headquarters Delegation of Authority Format

IHS Exhibit 8-101-G
General Administration Manual
IHS Transmittal 92.1

Department of Health and Human Services USA logo
     Indian Health Service
 Rockville MD 20852

TO: (Title(s) of Delegatee(s))

FROM: (Title of Delegating Official)

SUBJECT: Delegation of Authority (Add the citation of the enabling document or statute and general subject of the delegation exactly as it is from PHS)


Write the first paragraph of the delegation as follows:

  1. Pursuant to the authority delegated to the:

    1. (If after January 4 1988 Director, IHS, by the Director, Office of Management, PHS, (insert who is giving him/her this authority and what his/her office is) on (insert date of PHS delegation)

    2. (If prior to January 4, 1988 Director, IHS by the Reorganization Order of January 4, 1988, (5: FR 470531, (don't have to say the part about elevation)), and in accordance with the authority delegated to the PHS Agency Heads (say exactly who the PHS delegation goes to) on (insert date of PHS delegation)

  2. and redelegated to the Director of Headquarters Operations by the Director, IHS, on (Insert one of the following dates)

    1. September 21, 1989 (If the PHS delegation was made prior to September 21, 1989)

    2. August 23, 1990 (If the PHS delegation was made between September 21, 1989, and August 23, 1990)

    This statement is not used, if the delegation was made after August 23, 1990.  All of these delegations will need individual redelegations prepared from the Director, IHS, to the Director of Headquarters Operations.

    I hereby delegate to the (insert, who this authority is going to and what their area of authority is example:  to the Associate Director, Office of Administration and Management, for IHS Headquarters)

  3. Cite the authority being delegated exactly like it is in the PHS delegation.


This section usually takes one of the three forms listed below:

  1. This authority may be redelegated.

  2. This authority may not be redelegated.

  3. This authority may only be redelagated to (insert the position you are restricting the redelegation to).


Identify any restrictions and indicate to whom they apply.  Restrictions may limit the authority being redelegated or portions of it, or may limit the official(s) to whom it can be redelegated.


Specify sources of reference needed for exercising the authority, if any, in addition to the enabling document or statute cited above.


Specify the delegatian(s) that this delegation amends, supersedes, or cancels. Give date(s) and title(s) of delegation(s) being amended, superseded, or canceled. Provide for the continuation of any existing redelegations of this authority that are consistent with the new authority to allow time for updating,

For example:

This delegation supersedes the delegation contained in the Indian Health Manual, Part 1, Chapter 5, Subject:__________________,dated _____________,Transmittal Notice___________ .

If there is no supersession state "None."


State the date the delegation becomes effective.  (Usually it is the date of signature.)

Signature Block 

Any subsequent redelegations should follow the format listed above and the first paragraph should look something like this:

Pursuant to the authority delegated to the Associate Director, Office of Administration and Management, Indian Health Service (IHS), by the Director of Headquarters Operations, on (insert day), I hereby delegate to the (Insert who you're giving the authority to and the area of authority).

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