Supporting Healthy Marriage (SHM) Evaluation 12 month follow-up data collection

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Memo to OMB - Responses to follow-on Questions 04-14-08.doc	Supplementary Document	Uploaded 2008-04-23	Available
SHM Hypotheses and 12 Month Survey Questions_FINAL (2) 4-2-08 (2).doc	Supplementary Document	Uploaded 2008-04-23	Available
Memo to OMB - responses to Questions on SHM 12-mo 3-5-08 (3).doc	Supplementary Document	Uploaded 2008-04-23	Available
SHM PROJECT-12 month data collection OMB Justification statement.Section B.doc	Supporting Statement B	Uploaded 2007-12-11	Available
SHM PROJECT-12 month data collection OMB Justification statement.Appendices.doc	Supplementary Document	Uploaded 2007-12-06	Available
SHM 12 abstract.doc	Supplementary Document	Uploaded 2007-11-29	Available
SHM PROJECT-12 month data collection OMB Justification statement.Section A.doc	Supporting Statement A	Uploaded 2007-12-11	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
183233	Supporting Healthy Marriage (SHM) Project - 12 month follow up data collection. Instrument #3: Implementation Study Protocol	Other-Implementation Study Protocol	New
183232	Supporting Healthy Marriage (SHM) Project - 12 month follow up data collection. Instrument #2: Observational Study Protocol	Other-Observational Study Protocol	New
183231	Supporting Healthy Marriage (SHM) Project - 12 month follow up data collection. Instrument #1: Survey	Other-Survey Instrument	New

ICR Details

OMB Control No: 0970-0339	ICR Reference No: 200801-0970-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: Supporting Healthy Marriage (SHM) Evaluation 12 month follow-up data collection
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/23/2008
	Date Received in OIRA: 01/03/2008
Terms of Clearance: This information collection request is approved as amended by ACF's response memos of April 14th, April 2nd, and March 5th. Consistent with ACF's responses, the agency will evaluate its questionnaire via a pretest and should the survey instrument take longer than an average of 50 minutes to administer, ACF will consider measuring some constructs with fewer items. Should modification of the instruments be needed, ACF will advise OMB.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2011	36 Months From Approved
Responses	15,864	0	0
Time Burden (Hours)	11,793	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: See abstract uploaded as a word document.

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Authorizing Statute(s): PL: Pub.L. 42 - 131 1110 Name of Law: Social Security Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 57047	10/05/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 69696	12/10/2007
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Supporting Healthy Marriage (SHM) Project - 12 month follow up data collection. Instrument #2: Observational Study Protocol
Supporting Healthy Marriage (SHM) Project - 12 month follow up data collection. Instrument #3: Implementation Study Protocol
Supporting Healthy Marriage (SHM) Project - 12 month follow up data collection. Instrument #1: Survey

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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	15,864	0	0	15,864	0	0
Annual Time Burden (Hours)	11,793	0	0	11,793	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: This is a new data collection for a demonstration of programs to support healthy marriage among low-income couples with children.

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Annual Cost to Federal Government: $4,709,865

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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: 01/03/2008

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