OMB
.report
Search
Ryan White HIV/AIDS Program Data Report Form
Ryan White HIV/AIDS Program Data Report Form (formerly CADR System)
OMB: 0915-0253
IC ID: 6504
OMB.report
HHS/HSA
OMB 0915-0253
ICR 201012-0915-003
IC 6504
( )
Documents and Forms
Document Name
Document Type
Form 1
Ryan White HIV/AIDS Program Data Report Form
Form
1 Ryan White HIV/AIDS Program Data Report
2010_RDR_Form.doc
Form
2010_RDR_Instructions.doc
Instructions for Completing the Ryan White Data Report
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Ryan White HIV/AIDS Program Data Report Form
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
1
Ryan White HIV/AIDS Program Data Report
2010_RDR_Form.doc
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
2,647
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
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
2,647
0
0
-250
0
2,897
Annual IC Time Burden (Hours)
86,766
0
0
-7,476
0
94,242
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Instructions for Completing the Ryan White Data Report
2010_RDR_Instructions.doc
12/02/2010
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.