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OMB Control No: 0915-0318	ICR Reference No: 202603-0915-001
Status: Received in OIRA	Previous ICR Reference No: 202308-0915-001
Agency/Subagency: HHS/HSA	Agency Tracking No: 21434
Title: Ryan White HIV/AIDS Program Allocation Forms
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 03/17/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	04/30/2026
Responses	648	615
Time Burden (Hours)	2,300	2,568
Cost Burden (Dollars)	0	0

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	648	615	33
Annual Time Burden (Hours)	2,300	2,568	-268
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: There are no proposed changes to any of the forms. However, there is a small decline of 268 burden hours compared to the currently approved collection, due to RWHAP recipients’ familiarity with the updated reporting requirements introduced in the currently approved collection.   

Annual Cost to Federal Government: $207,690

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

Agency Contact: Laura Cooper 301 443-2126 lcooper@hrsa.gov

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