National Assessment of the Social Innovation Fund

Forms and Documents

Document Name	Status
Form 5 National Assessment of SIF Instruments Form and Instruction	New
SIF National Assessment OMB Part B 4 16 2015.docx Supporting Statement B	2015-04-16
SIF National Assessment OMB Part A 4 16 2015.docx Supporting Statement A	2015-04-16

IC Document Collections

IC ID	Document Title	Status
214653	National Assessment of SIF Instruments Form and Instruction	New

ICR Details

OMB Control No: 3045-0169	ICR Reference No: 201501-3045-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: CNCS	Agency Tracking No:
Title: National Assessment of the Social Innovation Fund
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/16/2015
	Date Received in OIRA: 01/15/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2018	36 Months From Approved
Responses	539	0	0
Time Burden (Hours)	207	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: CNCS is seeking approval of National Assessment of the Social Innovation Fund (SIF)], which is used by the Office of Research and Evaluation to collect information on the effects of participation in SIF on organizations and communities. The information is needed for program improvement and planning and to assess program impact.

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Authorizing Statute(s): US Code: 42 USC 12501 as amended Name of Law: National Community Service 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:
	79 FR 25115	05/02/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 1845	01/14/2015
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
National Assessment of SIF Instruments	1, 3, 4, 2, 5, 6, 7	2016 Survey of SIF Intermediaries ,   Survey of 2010-2012 Intermediaries ,   SIF Intermediary Evidence Interview ,   Survey of 2014 SIF Intermediaries ,   Survey of Non-funded Applicants ,   Survey of Nonprofit Comparison Group ,   2016 Survey of Non-Funded Applicants

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ICR Summary 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	539	0	0	539	0	0
Annual Time Burden (Hours)	207	0	0	207	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: th eburden has changed because this is a new information collection.

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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

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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: 01/15/2015

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