Information Collection

PEPFAR Program Expenditures

IC 264655 under ICR 202401-1405-005 · OMB 1405-0208.

Documents and Forms

Document Name Document Type
DS-4213 Reporting Form.xlsx Other-Spreadsheet
DS-4213 Reporting Form.xlsx Other-Spreadsheet

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
Other-Spreadsheet			DS-4213 Reporting Form.xlsx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: DS-4213 Reporting Form	FR Citation: 89 FR 12302

Number of Respondents: 4,045	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	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	4,045	565	3,480
Annual IC Time Burden (Hours)	68,765	15	68,750
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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