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 FVPSA TRIBAL PERFORMANCE REPORT	Form and Instruction	Modified	Repair queued
Form 1 FVPSA STATE PERFORMANCE REPORT	Form and Instruction	Modified	Available
Form 1 FVPSA STATE COALITION PROGRAM ANNOUNCEMENT	Form and Instruction	Modified	Available
Supporting Statement for OMB clearance 2011.doc	Supporting Statement A	Uploaded 2011-09-13	Repair queued

IC Document Collections

Information collection document groups

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

ICR Details

OMB Control No: 0970-0280	ICR Reference No: 201109-0970-002
Status: Historical Active	Previous ICR Reference No: 200810-0970-001
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: 11/06/2011
	Date Received in OIRA: 09/14/2011
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2014	36 Months From Approved	12/31/2011
Responses	562	0	558
Time Burden (Hours)	5,620	0	6,845
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:
	76 FR 12742	03/08/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 56461	09/13/2011
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 GRANT PROGRAM ANNOUNCEMENT
FVPSA TRIBAL PROGRAM ANNOUNCEMENT
FVPSA STATE COALITION PROGRAM ANNOUNCEMENT	1	PA
FVPSA STATE PERFORMANCE REPORT	1	States and Territories
FVPSA TRIBAL PERFORMANCE REPORT	1	Tribal PPR

---

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	562	558	0	0	4	0
Annual Time Burden (Hours)	5,620	6,845	0	0	-1,225	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: Although the approximate number of respondents has increased, the total burden hours has decreased because systems are already in place to collect the data and the templates for the application process have already been established.

---

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]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

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: 09/14/2011

---