EHE Triannual Module OMB Mockup

Ending the HIV Epidemic (EHE) Triannual Module

OMB: 0906-0051

IC ID: 240018

Information Collection (IC) Details

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EHE Triannual Module OMB Mockup
 
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 1 EHE Triannual Module_OMB mockup - FORM.docx EHE Triannual Module_OMB mockup - FORM.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

942 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 2,826 0 0 2,826 0 0
Annual IC Time Burden (Hours) 5,087 0 0 5,087 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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