Participant Information Form (PIF)

HRSA AIDS Education and Training Centers (AETCs) Evaluation Activities

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0281 can be found here:

Documents and Forms

Document Name Document Type
Form 2 Participant Information Form (PIF) Form
2 HRSA AETC PIF 2016 HRSA AETC_PIF_2016.doc Form

Information Collection (IC) Details

IC Title:	Participant Information Form (PIF)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	2	HRSA AETC PIF 2016	HRSA AETC_PIF_2016.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 114,423	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	114,423	114,423
Annual IC Time Burden (Hours)	8,010	8,010
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.