Information Collection

PEPFAR Program Expenditures

IC 204522 under ICR 201210-1405-004 · OMB 1405-0208.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0208 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DS-4213 (Master) PEPFAR Program Expenditures	Form
Expenditure Analysis Manual-Generic (10-31-2012).docx	Instruction
DS-4213 (Master) President's Emergency Plan for AIDS Relief (PEPFAR) Prog DS-4213 PEPFAR Expenditures Reporting Master (10-2012).xlsx pepfarpromis/promis	Form
DS-4213_PEPFAR_EA_Ethiopia.xlsx DS-4213 Ethiopia Reporting Template	IC Document
DS-4213_PEPFAR_EA_Kenya.xlsx DS-4213 Kenya Reporting Template	IC Document
DS-4213_PEPFAR_EA_Mozambique.xlsx DS-4213 Mozambique Reporting Template	IC Document
DS-4213_PEPFAR_EA_Namibia.xlsx DS-4213 Namibia Reporting Template	IC Document
DS-4213_PEPFAR_EA_Nigeria.xlsx DS-4213 Nigeria Reporting Template	IC Document
DS-4213_PEPFAR_EA_South Africa.xlsx DS-4213 South Africa Reporting Template	IC Document
DS-4213_PEPFAR_EA_Tanzania.xlsx DS-4213 Tanzania Reporting Template	IC Document
DS-4213_PEPFAR_EA_Uganda.xlsx DS-4213 Uganda Reporting Template	IC Document
DS-4213_PEPFAR_EA_Zambia.xlsx DS-4213 Zambia Reporting Template	IC Document

IC Title:

PEPFAR Program Expenditures

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

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	DS-4213 (Master)	President's Emergency Plan for AIDS Relief (PEPFAR) Program Expenditures	DS-4213 PEPFAR Expenditures Reporting Master (10-2012).xlsx	https://pepfarpromis/promis	Yes	Yes	Fillable Fileable
Instruction			Expenditure Analysis Manual-Generic (10-31-2012).docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,583

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,583	1,583
Annual IC Time Burden (Hours)	37,992	37,992
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
DS-4213 Ethiopia Reporting Template	DS-4213_PEPFAR_EA_Ethiopia.xlsx	10/18/2012
DS-4213 Kenya Reporting Template	DS-4213_PEPFAR_EA_Kenya.xlsx	10/18/2012
DS-4213 Mozambique Reporting Template	DS-4213_PEPFAR_EA_Mozambique.xlsx	10/18/2012
DS-4213 Namibia Reporting Template	DS-4213_PEPFAR_EA_Namibia.xlsx	10/18/2012
DS-4213 Nigeria Reporting Template	DS-4213_PEPFAR_EA_Nigeria.xlsx	10/18/2012
DS-4213 South Africa Reporting Template	DS-4213_PEPFAR_EA_South Africa.xlsx	10/18/2012
DS-4213 Tanzania Reporting Template	DS-4213_PEPFAR_EA_Tanzania.xlsx	10/18/2012
DS-4213 Uganda Reporting Template	DS-4213_PEPFAR_EA_Uganda.xlsx	10/18/2012
DS-4213 Zambia Reporting Template	DS-4213_PEPFAR_EA_Zambia.xlsx	10/18/2012

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