HIV Prevention Program Evaluation and Monitoring System for Health Departments and Community-Based Organizations (PEMS)

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Documents and Forms

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no available documents/forms check other ICs listed under this ICR

Information Collection (IC) Details

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IC Title:	HIV Prevention Program Evaluation and Monitoring System for Health Departments and Community-Based Organizations (PEMS)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

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: 219	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,152	2,152
Annual IC Time Burden (Hours)	122,172	122,172
Annual IC Cost Burden (Dollars)	2,000	2,000

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.