Information Collection

Request for Assistance for Child Victims of Human Trafficking

IC 188787 under ICR 200904-0970-002 · OMB 0970-0362.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0362 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Request for Assistance for Child Victims of Human Trafficking Form and Instruction
1 Request for Assistance Attachment B_Request for Assistance for Child Victims of Human Trafficking Doc1 04 09 09 (Simplified)_version2.doc Form and Instruction
ATIP Sex Trafficking Poster.pdf Sex Trafficking Poster IC Document
ATIP Social Services Migrant Poster.pdf ATIP Social Services Migrant Poster IC Document
Attachment A_TVPA U.S. Code cite authorizing collection of information.doc Attachment A_TVPA U IC Document
Draft state letter Doc5.doc Draft State Letter IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Request for Assistance for Child Victims of Human Trafficking	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Request for Assistance	Attachment B_Request for Assistance for Child Victims of Human Trafficking Doc1 04 09 09 (Simplified)_version2.doc		No	No	Paper Only

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	75	75
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Sex Trafficking Poster	ATIP Sex Trafficking Poster.pdf	04/10/2009
ATIP Social Services Migrant Poster	ATIP Social Services Migrant Poster.pdf	04/10/2009
Attachment A_TVPA U	Attachment A_TVPA U.S. Code cite authorizing collection of information.doc	04/10/2009
Draft State Letter	Draft state letter Doc5.doc	04/10/2009

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.