Information Collection

PEPFAR Program Expenditures

IC 204522 under ICR 201210-1405-004 · OMB 1405-0208.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0208 can be found here:

Documents and Forms

Document Name Document Type
Form DS-4213 (Master) PEPFAR Program Expenditures Form
Expenditure Analysis Manual-Generic (10-31-2012).docx Instruction
DS-4213 (Master) President's Emergency Plan for AIDS Relief (PEPFAR) Prog DS-4213 PEPFAR Expenditures Reporting Master (10-2012).xlsx pepfarpromis/promis Form
DS-4213_PEPFAR_EA_Ethiopia.xlsx DS-4213 Ethiopia Reporting Template IC Document
DS-4213_PEPFAR_EA_Kenya.xlsx DS-4213 Kenya Reporting Template IC Document
DS-4213_PEPFAR_EA_Mozambique.xlsx DS-4213 Mozambique Reporting Template IC Document
DS-4213_PEPFAR_EA_Namibia.xlsx DS-4213 Namibia Reporting Template IC Document
DS-4213_PEPFAR_EA_Nigeria.xlsx DS-4213 Nigeria Reporting Template IC Document
DS-4213_PEPFAR_EA_South Africa.xlsx DS-4213 South Africa Reporting Template IC Document
DS-4213_PEPFAR_EA_Tanzania.xlsx DS-4213 Tanzania Reporting Template IC Document
DS-4213_PEPFAR_EA_Uganda.xlsx DS-4213 Uganda Reporting Template IC Document
DS-4213_PEPFAR_EA_Zambia.xlsx DS-4213 Zambia Reporting Template IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	PEPFAR Program Expenditures	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DS-4213 (Master)	President's Emergency Plan for AIDS Relief (PEPFAR) Program Expenditures	DS-4213 PEPFAR Expenditures Reporting Master (10-2012).xlsx	https://pepfarpromis/promis	Yes	Yes	Fillable Fileable
Instruction			Expenditure Analysis Manual-Generic (10-31-2012).docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,583	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,583	1,583
Annual IC Time Burden (Hours)	37,992	37,992
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
DS-4213 Ethiopia Reporting Template	DS-4213_PEPFAR_EA_Ethiopia.xlsx	10/18/2012
DS-4213 Kenya Reporting Template	DS-4213_PEPFAR_EA_Kenya.xlsx	10/18/2012
DS-4213 Mozambique Reporting Template	DS-4213_PEPFAR_EA_Mozambique.xlsx	10/18/2012
DS-4213 Namibia Reporting Template	DS-4213_PEPFAR_EA_Namibia.xlsx	10/18/2012
DS-4213 Nigeria Reporting Template	DS-4213_PEPFAR_EA_Nigeria.xlsx	10/18/2012
DS-4213 South Africa Reporting Template	DS-4213_PEPFAR_EA_South Africa.xlsx	10/18/2012
DS-4213 Tanzania Reporting Template	DS-4213_PEPFAR_EA_Tanzania.xlsx	10/18/2012
DS-4213 Uganda Reporting Template	DS-4213_PEPFAR_EA_Uganda.xlsx	10/18/2012
DS-4213 Zambia Reporting Template	DS-4213_PEPFAR_EA_Zambia.xlsx	10/18/2012

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