Information Collection

Semi-annual Progress Report for the Grants to Support Tribal Domestic Violence and Sexual Assault Coalitions

IC 12649 under ICR 201409-1122-004 · OMB 1122-0011.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1122-0011 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1122-0011 Semi-annual Progress Report for the Grants to Support Tribal Domestic Violence and Sexual Assault Coalitions	Form
1122-0011 Semi Annual Progress Report for Tribal Coalitions Progra TribalCoalitionsFormGMSSample2014.docx www.gms.gov	Form

IC Title:

Semi-annual Progress Report for the Grants to Support Tribal Domestic Violence and Sexual Assault Coalitions

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1122-0011	Semi Annual Progress Report for Tribal Coalitions Program	TribalCoalitionsFormGMSSample2014.docx	www.gms.gov	Yes	Yes	Fillable Fileable Signable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 14

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	28	28
Annual IC Time Burden (Hours)	28	28
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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