Trac

Co-location and Integration of HIV Prevention and Medical Care into Behavioral Health Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0343 can be found here:

Documents and Forms

Document Name Document Type
Form TRAC TRAC Form and Instruction
TRAC TRAC Attachment 2 TRAC 6 17 2014.pdf Form and Instruction
Attachment 4 Composition of Proposed CoC TRACTool.docx Composition of Proposed CoC TRAC Tool IC Document

Information Collection (IC) Details

IC Title:	TRAC	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	TRAC	TRAC	Attachment 2 TRAC 6 17 2014.pdf		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,200	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,196	2,196
Annual IC Time Burden (Hours)	397	397
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Composition of Proposed CoC TRAC Tool	Attachment 4 Composition of Proposed CoC TRACTool.docx	06/26/2014

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