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Ryan White CARE Act Title I Minority AIDS Initiative Report: Title I Report
Ryan White CARE Act Title I Minority AIDS Initiative (MAI) Report: Title I Report
OMB: 0915-0304
IC ID: 46219
OMB.report
HHS/HSA
OMB 0915-0304
ICR 201003-0915-001
IC 46219
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0304 can be found here:
2013-07-10 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
OMB Attachment A Part A MAIscreenshots_FINAL_012810.doc
Other-MAI Screen Shots
OMB Attachment A Part A MAIscreenshots_FINAL_012810.doc
MAI Report screen shots
IC Document
OMB Attachment B Part A MAI Reporting Instructions_Jan 2010.doc
MAI Report Instructions
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Ryan White CARE Act Title I Minority AIDS Initiative Report: Title I Report
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
Other-MAI Screen Shots
OMB Attachment A Part A MAIscreenshots_FINAL_012810.doc
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
56
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 New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
112
0
0
10
0
102
Annual IC Time Burden (Hours)
560
0
0
-52
0
612
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
MAI Report screen shots
OMB Attachment A Part A MAIscreenshots_FINAL_012810.doc
03/11/2010
MAI Report Instructions
OMB Attachment B Part A MAI Reporting Instructions_Jan 2010.doc
03/11/2010
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.