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HIV testing & prevention services template -Community-Based Organization

IC 217851 under ICR 202605-0920-005 · OMB 0920-0696.

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HIV testing & prevention services template -Community-Based Organization 0920-26-0201
 
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
Form 0920-26-0201 Att 3A_HIV Testing and Prevention Services Template- CBO Att 3A_HIV Testing and Prevention Services Template for HDs and most CBOs_Revised.pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

 

114 0
   
Private Sector Not-for-profit institutions
 
   100 %

  Requested 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 228 0 -72 0 0 300
Annual IC Time Burden (Hours) 520 0 -15,680 0 0 16,200
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Data Variable Options Att 5B NHME Variables Options July 2018.docx 08/20/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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