Part B Allocation and Expenditure forms

Ryan White HIV/AIDS Program Allocation and Expenditure Forms

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0318 can be found here:

Documents and Forms

Document Name Document Type
Form B1 Part B Allocation and Expenditure forms Form
Part B Allocations Report - instructions.docx Instruction
CLC - instructions.pdf Instruction
B1 Part B Allocations Suppl Allocations Report.xlsx Part B Allocations Suppl Allocations Report_combined 9MAR2017.xlsx Form
B2 Part B Expenditures Suppl Allocations Report.xlsx Part B Expenditures Suppl Allocations Report_combined 9MAR2017.xlsx Form
B3 CLC CLC.pdf Form

Information Collection (IC) Details

IC Title:	Part B Allocation and Expenditure forms	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	B1	Part B Allocations Suppl Allocations Report.xlsx	Part B Allocations Suppl Allocations Report_combined 9MAR2017.xlsx	Yes	Yes	Fillable Fileable
Form	B2	Part B Expenditures Suppl Allocations Report.xlsx	Part B Expenditures Suppl Allocations Report_combined 9MAR2017.xlsx	Yes	Yes	Fillable Fileable
Instruction			Part B Allocations Report - instructions.docx	Yes	Yes	Fillable Fileable
Form	B3	CLC	CLC.pdf	Yes	Yes	Fillable Fileable
Instruction			CLC - instructions.pdf	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 54	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	Previously Approved
Annual Number of Responses for this IC	162	52	110
Annual IC Time Burden (Hours)	324	-996	1,320
Annual IC Cost Burden (Dollars)	0	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.