Information Collection

PEPFAR Program Expenditures

IC 204522 under ICR 201311-1405-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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 PEPFAR Program Expenditures	Form and Instruction
DS-4213 PEPFAR PROMIS Screenshots PEPFAR PROMIS Screenshots (11-13).pdf www.pepfarpromis.net/promis	Form and Instruction

IC Title:

PEPFAR Program Expenditures

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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 and Instruction	DS-4213	PEPFAR PROMIS Screenshots	PEPFAR PROMIS Screenshots (11-13).pdf	https://www.pepfarpromis.net/promis	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,581

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,581	-2	1,583
Annual IC Time Burden (Hours)	37,944	-48	37,992
Annual IC Cost Burden (Dollars)	0	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.