VICTIMS OF CRIME ACT, CRIME VICTIM COMPENSATION GRANT PROGRAM, PROGRAM INSTRUCTION AND APPLICATION KIT -- (1) ELIGIBLE STATE PAYMENTS CERTIFICATION FORM, ELIGIBLE ...
ICR 199201-1121-001
OMB: 1121-0170
Federal Form Document
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1121-0170 can be found here:
VICTIMS OF CRIME ACT, CRIME
VICTIM COMPENSATION GRANT PROGRAM, PROGRAM INSTRUCTION AND
APPLICATION KIT -- (1) ELIGIBLE STATE PAYMENTS CERTIFICATION FORM,
ELIGIBLE ...
New
collection (Request for a new OMB Control Number)
THE INFORMATION REQUESTED IS NECESSARY
TO CONFIRM ELIGIBILITY AND TO ENSURE COMPLIANCE WITH STATUTORY
CRITERIA FOR AN ANNUAL COMPENSATION GRANT FROM THE CRIME VICTIMS
FUND. THE AFFECTED PUBLIC INCLUDES UP TO 56 STATES AND TERRITORIES
ADMINISTERING THE CRIME VICTIM COMPENSATION PROVISIONS OF THE
VICTIMS OF CRIME ACT.
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.