Information Collection

Technical Assistance provided to Ryan White HIV/AIDS Program Grantees

IC 207948 under ICR 201206-0915-002 · OMB 0915-0212.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0212 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Technical Assistance provided to Ryan White HIV/AIDS Program Grantees	Form
1 Comprehensive Site Visit Baseline & Follow-up Survey - (Comprehensive Site Visit).pdf	Form
2 non-comprehensive site visit Baseline & Follow-up Survey (Non-Comprehensive Site Visit....pdf	Form
Email Content Baseline Survey for Comprehensive and Non-....pdf Email Content Baseline Survey for Comprehensive and Non-...	IC Document
Email Content for Follow-up Surveys (ABT).pdf Email Content for Follow-up Surveys (ABT)	IC Document
Supporting Statement.docx Supporting Statement	IC Document

IC Title:

Technical Assistance provided to Ryan White HIV/AIDS Program Grantees

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Comprehensive Site Visit	Baseline & Follow-up Survey - (Comprehensive Site Visit).pdf		Yes	Yes	Fillable Fileable
Form	2	non-comprehensive site visit	Baseline & Follow-up Survey (Non-Comprehensive Site Visit....pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 78

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	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	156	0	0	0	0	0
Annual IC Time Burden (Hours)	26	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Email Content Baseline Survey for Comprehensive and Non-...	Email Content Baseline Survey for Comprehensive and Non-....pdf	07/29/2013
Email Content for Follow-up Surveys (ABT)	Email Content for Follow-up Surveys (ABT).pdf	07/29/2013
Supporting Statement	Supporting Statement.docx	07/29/2013

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