Ryan White HIV/AIDS Program (RWHAP) Parts A and B Unobligated Balances and Rebate Addendum Tables.

Forms and Documents

Document	Type	Status	Availability
Form 2 Part B UOB Table	Form and Instruction	Modified	Available
Form 2 Part B UOB Table	Form and Instruction	Modified	Repair queued
Form 1 Part A UOB Table	Form	Modified	Available
Form 1 Part A UOB Table	Form	Modified	Repair queued
UOB Supporting Statement_Final for Submission 12 15 2025.docx	Supporting Statement A	Uploaded 2026-01-07	Available
UOB Supporting Statement_Final for Submission 12 15 2025.docx	Supporting Statement A	Uploaded 2026-01-07	Repair queued
legislation-title-xxvi.pdf	Supplementary Document	Uploaded 2023-04-10	Available
legislation-title-xxvi.pdf	Supplementary Document	Uploaded 2023-04-10	Repair queued

IC Document Collections

IC ID	Collection	Type	Status	Form
238609	RWHAP UOB Tables Summary	Form and Instruction	Modified	Part B UOB Table
238609	RWHAP UOB Tables Summary	Form and Instruction	Modified	Part B UOB Table
238609	RWHAP UOB Tables Summary	Form	Modified	Part A UOB Table
238609	RWHAP UOB Tables Summary	Form	Modified	Part A UOB Table

ICR Details

OMB Control No: 0906-0047	ICR Reference No: 202601-0906-001
Status: Active	Previous ICR Reference No: 202304-0906-001
Agency/Subagency: HHS/HRSA	Agency Tracking No:
Title: Ryan White HIV/AIDS Program (RWHAP) Parts A and B Unobligated Balances and Rebate Addendum Tables.
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/15/2026
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/08/2026
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2029	36 Months From Approved	05/31/2026
Responses	111	0	111
Time Burden (Hours)	56	0	56
Cost Burden (Dollars)	0	0	0

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Abstract: HRSA’s Ryan White HIV/AIDS Program (RWHAP) funds and coordinates with cities, states and territories, and local clinics/community-based organizations to deliver efficient and effective HIV care, treatment, and support to low-income people diagnosed with HIV. Grant recipients funded under Parts A and B of the RWHAP (codified under Title XXVI of the Public Health Service Act) are required to report financial data to HRSA annually in their Federal Financial Report (FFR SF-425). In addition to the FFR, the RWHAP Parts A and B grant recipients are required to identify and report the unobligated balance (UOB) by itemized subprogram/funding stream source (Formula, Minority AIDS Initiative [MAI], AIDS Drug Assistance Program [ADAP], etc.). As of April 22, 2021, the grant recipients must submit the subprogram breakdown of the UOB on their FFR in the Payment Management System (PMS). Grant recipients are also required to specify RWHAP Rebate Funding received in the fiscal year in the UOB table. HRSA uses the UOB and rebate addendum financial information to determine formula funding as directed by the RWHAP statute.

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Authorizing Statute(s): PL: Pub.L. 111 - 87 XXVI, RWHAP Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 42253	08/29/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 510	01/07/2026
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
RWHAP UOB Tables Summary	1, 2	Part A UOB Table ,   Part B UOB Table

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ICR Summary of Burden

	Total Approved	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	111	111	0	0	0	0
Annual Time Burden (Hours)	56	56	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $64,440

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 01/08/2026

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