MAI Report for Part B

Ryan White HIV/AIDS Program Allocation and Expenditure Forms

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0318 can be found here:

Documents and Forms

Document Name Document Type
Form 4b MAI Report for Part B Form
Instructions for PART B (with EHBs Instructions).doc Instruction
4b Part B Expenditures Report Part B Expendiutres Report.xls Form
4a Part B Allocations Report Part B Allocations Report.xls Form

Information Collection (IC) Details

IC Title:	MAI Report for Part B	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	4b	Part B Expenditures Report	Part B Expendiutres Report.xls	Yes	Yes	Fillable Fileable
Instruction			Instructions for PART B (with EHBs Instructions).doc	Yes	No	Printable Only
Form	4a	Part B Allocations Report	Part B Allocations Report.xls	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 59	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	118	118
Annual IC Time Burden (Hours)	472	472
Annual IC Cost Burden (Dollars)	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.