Supportive Services for Veteran Families (SSVF) Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form VA Form 10-10072c Renewal Application for Supportive Services Grant	Form and Instruction	Modified	Available
Form VA Form 10-10072b Quarterly Grantee Performance Report	Form and Instruction	Modified	Available
Form VA Form 10-10072a SSVF Participant Satisfaction Survey	Form	Modified	Available
Form VA Form 10-10072 Supportive Services for Veterans Families Progrm Application	Form and Instruction	Modified	Available
VAIQ 7393124 - SSVF NOFA v12-6-13 clean.docx	Supplementary Document	Uploaded 2013-12-19	Available
Memo on revisions to 2900-0757.pdf	Supplementary Document	Uploaded 2013-12-19	Available
White Paper revisions to 10-10072a SSVF Participant Satisfaction Survey.docx	Supplementary Document	Uploaded 2013-11-18	Available
SSVF Justification B_2900-0757_8-13.doc	Supporting Statement B	Uploaded 2013-08-21	Available
SSVF Justification A_2900-0757_12-27(v2).doc	Supporting Statement A	Uploaded 2014-01-07	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
194740	Supportive Services for Veteran Families Program	Form and Instruction	Modified	Renewal Application for Supportive Services Grant
194740	Supportive Services for Veteran Families Program	Form and Instruction	Modified	Quarterly Grantee Performance Report
194740	Supportive Services for Veteran Families Program	Form	Modified	SSVF Participant Satisfaction Survey
194740	Supportive Services for Veteran Families Program	Form and Instruction	Modified	Supportive Services for Veterans Families Progrm Application
194740	Supportive Services for Veteran Families Program	Other-worksheet	Modified

ICR Details

OMB Control No: 2900-0757	ICR Reference No: 201308-2900-011
Status: Historical Active	Previous ICR Reference No: 201210-2900-001
Agency/Subagency: VA	Agency Tracking No: 2900-0757
Title: Supportive Services for Veteran Families (SSVF) Program
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 01/08/2014
Retrieve Notice of Action (NOA)	Date Received in OIRA: 12/19/2013
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2017	36 Months From Approved	01/31/2014
Responses	24,480	0	100
Time Burden (Hours)	25,505	0	3,500
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of the SSVF Program is to provide supportive services grants to private non-profit organizations and consumer cooperatives who will coordinate or provide supportive services to very low-income veteran families who are residing in permanent housing, are homeless and scheduled to become residents of permanent housing within a specified time period, or after exiting permanent housing, are seeking other housing that is responsive to such very low-income veteran family’s needs and preferences. The new SSVF Program is within the continuum of VA’s homeless services programs.

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Authorizing Statute(s): US Code: 38 USC 2044 Name of Law: Financial Assistance for Supportive Services
   PL: Pub.L. 110 - 387 604 Name of Law: Veterans¿ Mental Health and Other Care Improvements 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:
	78 FR 166	08/27/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 70414	11/25/2013
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
Supportive Services for Veteran Families Program	VA Form 10-10072c, VA Form 10-10072a, VA Form 10-10072, VA Form 10-10072b	Supportive Services for Veterans Families Progrm Application ,   SSVF Participant Satisfaction Survey ,   Quarterly Grantee Performance Report ,   Renewal Application for Supportive Services 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	24,480	100	0	24,380	0	0
Annual Time Burden (Hours)	25,505	3,500	0	22,005	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: The respondent total increased for SSVF form 10-10072 by 300. This resulted in an increase for the Renewal Application by 270 and an increase for the Compliance Report by 290. There was a burden increase, after the 30-day FRN due to an error in Program Office calculations. The adjustment was made accordingly.

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Annual Cost to Federal Government: $43,070

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

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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: 12/19/2013

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