Information Collection Request

Ryan White HIV/AIDS Program Client-Level Data Reporting System

ICR 201811-0906-001 · OMB 0906-0039 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 3 2018 RSR Client Level Data Elements Instrument.docx Form New Available
Form 2 2018_Service_Provider_Form_Screenshots Form New Available
Form 1 2018_RSR_Grantee_Report_Screenshots_Instrument.docx Form New Available
FINALRSR Supporting Statement.docx Supporting Statement A Uploaded 2018-11-01 Available
2017 RSR Manual Final.pdf Supplementary Document Uploaded 2018-11-01 Available
Summary of Changes 2019 RSR OMB.docx Supplementary Document Uploaded 2018-11-01 Available
Burden Estimate Responses (003).docx Supplementary Document Uploaded 2018-11-01 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
233867 Ryan White Services Client Report Form New2018 RSR Client Level Data Elements Instrument.docx
233866 Ryan White Services Report Service Provider Report Form New2018_Service_Provider_Form_Screenshots
233865 Ryan White Services Report Grantee Report Form New2018_RSR_Grantee_Report_Screenshots_Instrument.docx

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2021 36 Months From Approved
4,161 0 0
213,843 0 0
0 0 0





Reginfo record details
3
table that charts list of burden
IC Title Form No. Form Name
Ryan White Services Client Report 3
Ryan White Services Report Grantee Report 1
Ryan White Services Report Service Provider Report 2

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 4,161 0 0 4,161 0 0
Annual Time Burden (Hours) 213,843 0 0 213,843 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No