Information Collection

Ryan White Miority AIDS Initiative Providers -service providers

IC 202696 under ICR 201206-0990-003 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
0990-RW Study Appendix F - Grantee Guide_May 22.docx	Other-interview
0990-RW Study Appendix G - Provider Guide_May 22.docx	Other-guide

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

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
Other-interview			0990-RW Study Appendix F - Grantee Guide_May 22.docx		No	No	Paper Only
Other-guide			0990-RW Study Appendix G - Provider Guide_May 22.docx		No	No	Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 133

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector:

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	133	133
Annual IC Time Burden (Hours)	122	122
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.