View Information Collection (IC)

View Information Collection (IC)

IC Title:	Centers for Disease Control and Prevention Ending the HIV Epidemic in the United States: Performance Measures	Agency IC Tracking Number:	0920-1282-21EA

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Indicators Reporting Tables	Att 1_PS20-2010_PS20-2004 Indicators Reporting Tables 5-13-2021_DHAP_DSTDP_Final.xlsx		Yes	Yes	Fillable Fileable
Form	none	Technical Specifications	Att 2_PS20-2010_PS20-2004 Technical Specifications 5-13-2021_DHAP_DSTDP_Final.xlsx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 61	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 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	122	0	122	0	0	0
Annual IC Time Burden (Hours)	2,660	0	2,660	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
genIC Request for Approval	PPEO GenIC RequestTemplate - PS20-2010_PS20-2004 Request 5-13-2021_DHAP_DSTDP_Final.docx	05/13/2021

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