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Part A Expenditures Report
Ryan White HIV/AIDS Program Expenditure Forms
OMB: 0915-0390
IC ID: 260457
OMB.report
HHS/HSA
OMB 0915-0390
ICR 202308-0915-002
IC 260457
( )
Documents and Forms
Document Name
Document Type
Form 1
Part A Expenditures Report
Form
1 Part A Expenditures Report and Changes Summary
Part A Expenditures Report and Changes Summary.pdf
Form
1 Part A Expenditures Report and Changes Summary
Part A Expenditures Report and Changes Summary.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Part A Expenditures Report
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
1
Part A Expenditures Report and Changes Summary
Part A Expenditures Report and Changes Summary.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:
52
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
52
0
0
0
0
52
Annual IC Time Burden (Hours)
208
0
0
0
0
208
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.