Information Collection Request

Ryan White HIV/AIDS Program Client-Level Data Reporting System

ICR 202407-0906-003 · OMB 0906-0039 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 3 Client Report Form and Instruction New Missing upstream
Form 2 Provider Report Form and Instruction New Repair queued
Form 1 Recipient Report Form and Instruction New Repair queued
Form 1 Ryan White Services Report Manual Form and Instruction Removed Missing upstream
Tab A - 2009 RWHAP Legislation.pdf Supplementary Document Uploaded 2021-11-16 Repair queued
Supporting Statement A - RSR 2024 Final 07012024.docx Supporting Statement A Uploaded 2024-07-16 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
269447 Client Report Form and Instruction New
269446 Provider Report Form and Instruction New
269445 Recipient Report Form and Instruction New
233865 Ryan White Services Report Manual Form and Instruction Removed

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 12/31/2024
4,190 4,190
206,480 206,480
0 0





Reginfo record details
3
table that charts list of burden
IC Title Form No. Form Name
Client Report 3 Client Report
Provider Report 2 Provider Report
Recipient Report 1 Recipient Report
Ryan White Services Report Manual 1 2021_DRAFT RSR_Manual.pdf

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 4,190 4,190 0 0 0 0
Annual Time Burden (Hours) 206,480 206,480 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No