ADAP Client Report

AIDS Drug Assistance Program (ADAP) Data Report

OMB: 0915-0345

IC ID: 199934

Documents and Forms
Document Name
Document Type
Instruction
Information Collection (IC) Details

View Information Collection (IC)

ADAP Client Report
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction Client-Level Data Elements.docx Yes Yes Fillable Fileable

Health Health Care Services

 

54 0
   
State, Local, and Tribal Governments
 
   100 %

  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 54 0 -60 0 0 114
Annual IC Time Burden (Hours) 324 0 -3,574 0 0 3,898
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.

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