Information Collection

Supplement to HIV/AIDS Surveillance (SHAS) Project

IC 6718 under ICR 200103-0920-001 · OMB 0920-0262.

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Supplement to HIV/AIDS Surveillance (SHAS) Project	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,625	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,625	125	3,500
Annual IC Time Burden (Hours)	3,625	125	3,500
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.