Part C Allocation and Expenditure forms

Ryan White HIV/AIDS Program Allocation and Expenditure Forms

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0318 can be found here:

Documents and Forms

Document Name Document Type
Instructions for PART C (with EHBs Instructions).doc Instruction
5a Part C Allocations Report and Checklist Part C Allocations Report.xls Form
5b Part C Expenditures Report and Checklist Part C Expenditures Report.xls Form

Information Collection (IC) Details

IC Title:	Part C Allocation and Expenditure forms	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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Instructions for PART C (with EHBs Instructions).doc	Yes	No	Printable Only
Form	5a	Part C Allocations Report and Checklist	Part C Allocations Report.xls	Yes	Yes	Fillable Fileable
Form	5b	Part C Expenditures Report and Checklist	Part C Expenditures Report.xls	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 361	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	722	722
Annual IC Time Burden (Hours)	5,054	5,054
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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