ADAP Grantee Report and Client Level Data Elements Report

AIDS Drug Assistance Program (ADAP) Data Report

OMB: 0915-0345

IC ID: 199933

Information Collection (IC) Details

View Information Collection (IC)

ADAP Grantee Report and Client Level Data Elements 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
Form B B - ADR Grantee Report.docx B - ADR Grantee Report.docx Yes Yes Fillable Fileable
Instruction D - Instruction Manual 2016 ADR_11042016_FINAL_508.pdf Yes Yes Fillable Fileable
Form C C - ADR Client-Level Data Elements 2017.docx C - ADR Client-Level Data Elements 2017.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 0 0 0 54
Annual IC Time Burden (Hours) 4,698 0 324 0 0 4,374
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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