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Participant Information Form (PIF)
HRSA AIDS Education and Training Centers (AETCs) Evaluation Activities
OMB: 0915-0281
IC ID: 221598
OMB.report
HHS/HSA
OMB 0915-0281
ICR 202006-0915-005
IC 221598
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0281 can be found here:
2022-06-30 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form D
Participant Information Form (PIF)
Form
D Participation Information Form 218
D_Participation Information Form 2018_Final.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Participant Information Form (PIF)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
D
Participation Information Form 218
D_Participation Information Form 2018_Final.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
61,288
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
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
61,288
0
0
0
0
61,288
Annual IC Time Burden (Hours)
3,064
0
0
0
0
3,064
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.