HIV/AIDS Bureau Core Medical Services Waiver

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0307 can be found here:

Documents and Forms

Document Name Document Type
Form 1 HIV/AIDS Bureau Core Medical Services Waiver Form and Instruction
1 1 Waiver definitions.doc Form and Instruction
hiv waiver law.doc waiver legislation IC Document
waiver letters 2007.pdf waiver letters IC Document
waiver memo 2007.pdf waiver memo 2007 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	HIV/AIDS Bureau Core Medical Services Waiver	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	1	Waiver definitions.doc		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	130	130
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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