Family Violence Prevention and Services: Grants to States; Native American Tribes and Alaskan Native Villages; and State Domestic Violence Coalitions

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Tribal Performace Report	Form and Instruction	New	Available
Form 1 STATE PERFORMANCE REPORT	Form and Instruction	New	Available
Form 1 PA	Form and Instruction	New	Available
Form 1 PA	Form and Instruction	New	Available
Form 1 PA	Form and Instruction	Modified	Available
Supporting Statement Revised.doc	Supporting Statement A	Uploaded 2008-09-11	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
186809	FVPSA TRIBAL PERFORMANCE REPORT	Form and Instruction	New	Tribal Performace Report
186808	FVPSA STATE PERFORMANCE REPORT	Form and Instruction	New	STATE PERFORMANCE REPORT
186807	FVPSA STATE COALITION PROGRAM ANNOUNCEMENT	Form and Instruction	New	PA
186806	FVPSA TRIBAL PROGRAM ANNOUNCEMENT	Form and Instruction	New	PA
10138	FVPSA STATE GRANT PROGRAM ANNOUNCEMENT	Form and Instruction	Modified	PA

ICR Details

OMB Control No: 0970-0280	ICR Reference No: 200810-0970-001
Status: Historical Active	Previous ICR Reference No: 200509-0970-003
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: Family Violence Prevention and Services: Grants to States; Native American Tribes and Alaskan Native Villages; and State Domestic Violence Coalitions
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/14/2008
Retrieve Notice of Action (NOA)	Date Received in OIRA: 10/03/2008
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2011	36 Months From Approved	12/31/2008
Responses	558	0	286
Time Burden (Hours)	6,845	0	1,716
Cost Burden (Dollars)	0	0	0

---

Abstract: The information that we receive and compile from the annual program reports is used in the development of planning guidance provided to the field, for staff training, program improvement actions, and used in the development of our discretionary programs.

---

Authorizing Statute(s): US Code: 42 USC 10401 Name of Law: Family Violence Prevention
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 20304	04/15/2008
30-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 165	08/25/2008
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 5

table that charts list of burden

IC Title	Form No.	Form Name
FVPSA STATE COALITION PROGRAM ANNOUNCEMENT	1	PA
FVPSA STATE GRANT PROGRAM ANNOUNCEMENT	1	PA
FVPSA STATE PERFORMANCE REPORT	1	STATE PERFORMANCE REPORT
FVPSA TRIBAL PERFORMANCE REPORT	1	Tribal Performace Report
FVPSA TRIBAL PROGRAM ANNOUNCEMENT	1	PA

---

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	558	286	0	0	272	0
Annual Time Burden (Hours)	6,845	1,716	0	0	5,129	0
Annual Cost Burden (Dollars)	0	0	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:

---

Annual Cost to Federal Government: $0

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

---

Common Form ICR:  No

---

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: 10/03/2008

---