Ryan White Services Report Service Provider Report

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

OMB: 0906-0039

IC ID: 233866

Information Collection (IC) Details

View Information Collection (IC)

Ryan White Services Report Service Provider Report
 
No New
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 2 2018_Service_Provider_Form_Screenshots C - 2018_Service_Provider_Form_Screenshots_4242018_updated_final_RSR Instrument.docx Yes Yes Fillable Fileable

Health Health Care Services

 

2,079 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 2,079 0 2,079 0 0 0
Annual IC Time Burden (Hours) 27,027 0 27,027 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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