Information Collection Request

Ryan White HIV/AIDS Program Mpox Vaccine Distribution

ICR 202307-0915-004 · OMB 0915-0395 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 3 Wastage Upload Report Form New Repair queued
Form 2 Therapeutic Courses (Administered and Available) Form New Repair queued
Form 1 RWHAP MPx Vaccine Distribution Request Table Form New Repair queued
Supporting Statement Mpox 7.13.22 FINAL.docx Supporting Statement A Uploaded 2023-07-21 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
261185 Wastage Upload Report Form New
261184 Therapeutic Courses (Administered and Available) Form New
261183 RWHAP MPx Vaccine Distribution Request Table Form New

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved
5,985 0
1,375 0
0 0





table that charts list of burden
  Total Request 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 5,985 0 0 5,985 0 0
Annual Time Burden (Hours) 1,375 0 0 1,375 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No