Request for State Data Needed to Determine the Amount of a Tribal Family Assistance Grant

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
SUPPORTING STATEMENT with changes.doc	Supporting Statement A	Uploaded 2007-11-15	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
9969	Request for State Data Needed to Determine the Amount of a Tribal Family Assistance Grant	Other-Letter	Modified

ICR Details

OMB Control No: 0970-0173	ICR Reference No: 200711-0970-001
Status: Historical Active	Previous ICR Reference No: 200409-0970-002
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: Request for State Data Needed to Determine the Amount of a Tribal Family Assistance Grant
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 02/01/2008
	Date Received in OIRA: 11/16/2007
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2011	36 Months From Approved	01/31/2008
Responses	15	0	1
Time Burden (Hours)	630	0	630
Cost Burden (Dollars)	80,000	0	80,000

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Abstract: 42 U.S.C. 612 (section 412 of the Social Security Act -- the Act) gives Federally recognized Indian Tribes the opportunity to apply to operate a Tribal Temporary Assistance for Needy Families program. The Act specifies that the Secretary shall use State submitted data to make each determination of the amount of the grant to the Tribe. This form (letter) is used to request that data from the States.

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Authorizing Statute(s): US Code: 42 USC 612 Name of Law: PRWORA
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0970-AB78	Final or interim final rulemaking	65 FR 8477	02/18/2000

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 133	01/03/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 33763	06/19/2007
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Request for State Data Needed to Determine the Amount of a Tribal Family Assistance Grant

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ICR Summary of Burden

table that charts list of burden

	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	15	1	0	0	14	0
Annual Time Burden (Hours)	630	630	0	0	0	0
Annual Cost Burden (Dollars)	80,000	80,000	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $32,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 11/16/2007

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