OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Client Report

IC 269447 under ICR 202506-0906-004 · OMB 0906-0039.

Documents and Forms
Document Name
Document Type
Form and Instruction
Other-Redline
Other-Redline
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Client Report
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Redline Form 3 Ryan White Services Report_ Client Level Data on File_ OMB 0906-0039_06.13.2025 (Redline).docx Yes Yes Fillable Fileable
Form and Instruction 3 Client Level Data on File Form 3 Ryan White Services Report_ Client Level Data on File_ OMB 0906-0039_06.13.2025 (Clean).docx Yes Yes Fillable Fileable

Health Health Care Services

 

1,532 0
   
State, Local, and Tribal Governments
 
   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 1,532 0 0 0 0 1,532
Annual IC Time Burden (Hours) 173,116 0 0 0 0 173,116
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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