Information Collection

M&E Data Elements on HIV Prevention and Care Services (THRIVE Partners)

IC 224629 under ICR 201801-0920-001 · OMB 0920-1178.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1178 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment 4 ME Variables 112816.docx	Instruction
Att 4 Clean_ME Variables.docx	Instruction

IC Title:

M&E Data Elements on HIV Prevention and Care Services (THRIVE Partners)

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Attachment 4 ME Variables 112816.docx		Yes	Yes	Fillable Fileable
Instruction			Att 4 Clean_ME Variables.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 80

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	160	160
Annual IC Time Burden (Hours)	1,440	1,440
Annual IC Cost Burden (Dollars)	37,224	37,224

Documents for IC

table that charts IC Documents
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.