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Federal forms, ICRs, and supporting documents

Information Collection Request

Evaluating CDC Funded Health Department HIV Prevention Programs

ICR 200410-0920-007 · OMB 0920-0497 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
6938 Evaluating CDC Funded Health Department HIV Prevention Programs Migrated
ICR Details
0920-0497 200410-0920-007
Historical Active 200010-0920-001
HHS/CDC
Evaluating CDC Funded Health Department HIV Prevention Programs
Revision of a currently approved collection   No
Regular
Approved without change 11/18/2004
Retrieve Notice of Action (NOA) 10/20/2004
OMB approves this information collection request under the following Terms: CDC will incorporate the forms approved under this clearance into the PEMS system. When CDC submits the information request for the PEMS system to OMB OMB expects the Agency to request appropriate burden hours for the phase in of electronic versions of the forms and provide screen shots of the updated forms.
  Inventory as of this Action Requested Previously Approved
04/30/2006 04/30/2006 11/30/2004
195 0 1,040
196 0 1,248
0 0 0
This data collection consists of 3 forms: the PCRS reporting form provides the necessary mechanism for reporting aggregate HIV prevention program data and 2 budget forms which grantees use to inform CDC how federal funds are allocated.
None
None
No
1
IC Title Form No. Form Name
Evaluating CDC Funded Health Department HIV Prevention Programs
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 195 1,040 0 -845 0 0
Annual Time Burden (Hours) 196 1,248 0 -1,052 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
10/20/2004