Information Collection

FY 2020 Ending the HIV Epidemic - Primary Care HIV Prevention (PHCP) Progress Reporting

IC 207854 under ICR 202603-0915-004 · OMB 0915-0285.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 29 FY2020 Ending the HIV Epidemic Primary Care HIV Prevention PCHP Progress Reporting.docx FY 2020 Ending the HIV Epidemic - Primary Care HIV Prevention (PHCP) Progress Reporting	Form and Instruction
Form 29 Progress Report PCHP Mark Up_add new report 10.30.20.docx FY 2020 Ending the HIV Epidemic - Primary Care HIV Prevention (PHCP) Progress Reporting	Form and Instruction
29 FY2020 Ending the HIV Epidemic Primary Care HIV Preventi FY2020 Ending the HIV Epidemic Primary Care HIV Prevention PCHP Progress Reporting.docx	Form and Instruction
29 Progress Report PCHP Mark Up_add new report 10.30.20.doc Progress Report PCHP Mark Up_add new report 10.30.20.docx	Form and Instruction
Change Memo - OMB PPR 2020_HRSA BPHC 11-24-2020.docx Change Memo - OMB PPR 2020_HRSA BPHC 11-24-2020	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	29				Yes	Yes	Fillable Fileable
Form and Instruction	29				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 182

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-182	182
Annual IC Time Burden (Hours)	-182	182
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Change Memo - OMB PPR 2020_HRSA BPHC 11-24-2020		11/30/2020

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

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