4 Part D Expenditure Report

Ryan White HIV/AIDS Program Expenditure Forms

Part D Expenditure Report.xlsx

OMB: 0915-0390

Document [xlsx]
Download: xlsx | pdf

Overview

Expenditures Report
File Upload


Sheet 1: Expenditures Report





Expenditures Report






























H12HA26XXX-XXX


























Budget Year: 8/1/2021 - 7/31/2022










Report ID: XXX


























Report Status: Submitted










Last Modified Date: 10/28/2022 11:57 AM
























































































































































































Recipient Information


















Budget Year Award Information





Official Mailing Address: XXX

1. RWHAP Part D Recipient Award Amount $0





EIN: XXX

2. RWHAP Part D Approved Carryover Amount $0





UEI: XXX
















Preparer's Name: XXX
















Preparer's Title: XXX
















Preparer's Phone: XXX
















Preparer's Fax: XXX
















Preparer's Email: XXX



















































Prior FY Carryover Reporting FY Total







Amount Percent Amount Percent Amount Percent















$0 0.00% $966 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 100.00% $0 0.00%











$0










































Prior FY Carryover Reporting FY Total







Amount Percent Amount Percent Amount Percent















$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%





















$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% 0 0.00% $0 0.00%















$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%







$0 0.00% $0 0.00% $0 0.00%

















































$0

















































Amount







$0







$0

































Public Burden Statement:

The purpose of this data collection system is to collect allocations/expenditures information regarding Ryan White HIV/AIDS Program (RWHAP) Parts A, B, C, D grant funding. HAB will use these data to show the impact of RWHAP funding on the care and treatment of people with HIV in the United States. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this information collection is 0915-0318 and it is valid until 09/30/2023. This information collection is mandatory (through increased Authority under the Public Health Service Act, Section 311(c) (42 USC 243(c)) and title XXVI (42 U.S.C. §§ 300ff-11 et seq.). Public reporting burden for this collection of information is estimated to average 4 hours per response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 14N136B, Rockville, Maryland, 20857 or [email protected]




Sheet 2: File Upload



File Upload














H12HA26263 - ACADIANA CARES INC













Budget Year: 8/1/2021 - 7/31/2022

Report ID: 123255












Report Status: Submitted

Last Modified Date: 10/28/2022 11:57 AM












































Submission Components
Document Name Description Uploaded File Size Date Attached
File Typeapplication/vnd.openxmlformats-officedocument.spreadsheetml.sheet
File Modified0000-00-00
File Created0000-00-00

© 2024 OMB.report | Privacy Policy