View Information Collection (IC)

View Information Collection (IC)

IC Title:	FY 2020 Ending the HIV Epidemic - Primary Care HIV Prevention (PHCP) Progress Reporting	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

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 and Instruction	29	FY2020 Ending the HIV Epidemic Primary Care HIV Prevention PCHP Progress Reporting.docx	FY2020 Ending the HIV Epidemic Primary Care HIV Prevention PCHP Progress Reporting.docx		Yes	Yes	Fillable Fileable
Form and Instruction	29	Progress Report PCHP Mark Up_add new report 10.30.20.docx	Progress Report PCHP Mark Up_add new report 10.30.20.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

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 %

	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	182	0	0	0	0	182
Annual IC Time Burden (Hours)	182	0	0	0	0	182
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Change Memo - OMB PPR 2020_HRSA BPHC 11-24-2020	Change Memo - OMB PPR 2020_HRSA BPHC 11-24-2020.docx	11/30/2020

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