National Guard Youth ChalleNGe Job ChalleNGe Evaluation

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form BIF Baseline information forms (BIF) for youth	Form and Instruction	New	Available
Youth ChalleNGe Evaluation OMB Part A revised 2016 -final 3 25 2016.docx	Supporting Statement A	Uploaded 2016-03-31	Available
Youth Challenge_InformedConsentForm_10 13 15.doc	Supplementary Document	Uploaded 2015-10-13	Available
National Guard Youth ChalleNGe Job ChalleNGe Youth Consent Form_2016 - final 3 25 2018.doc	Supplementary Document	Uploaded 2016-03-31	Available
National Guard Youth ChalleNGe Job ChalleNGe Parent Consent Form_2016 - final 3 25 16.doc	Supplementary Document	Uploaded 2016-03-31	Available
NGYC Part B Approval.pdf	Supplementary Document	Uploaded 2015-09-17	Available
NGYC 60 day notice 2015-18076.pdf	Supplementary Document	Uploaded 2015-09-17	Available
Youth ChalleNGe Evaluation OMB Part B revised 2016 - final 3 25 2016.docx	Supporting Statement B	Uploaded 2016-03-31	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
218244	Site visit youth focus group protocol	Other-site visit protocol for youth	New
218243	Site visit employer protocol	Other-Site visit employer protocol	New
218242	Site visit master staff protocol	Other-Site visit staff protocol	New
218241	Baseline information forms (BIF) for youth	Form and Instruction	New

ICR Details

OMB Control No: 1291-0008	ICR Reference No: 201509-1291-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOL/OASAM	Agency Tracking No:
Title: National Guard Youth ChalleNGe Job ChalleNGe Evaluation
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: 03/31/2016
	Date Received in OIRA: 01/12/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2019	36 Months From Approved
Responses	1,769	0	0
Time Burden (Hours)	308	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: DOL is funding three National Guard Youth ChalleNGe programs to expand the program's target population to include court-involved youth and add a five-month residential occupational training component called Job ChalleNGe. The National Guard Youth ChalleNGe Job ChalleNGe Evaluation, sponsored by DOL's Chief Evaluation Office, will use (1) a set of interviews with staff and youth to learn how these program enhancements are implemented, and (2) a series of two randomized controlled trials to measure how effective they are for youth served, including for court-involved youth.

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Authorizing Statute(s): PL: Pub.L. 105 - 220 171 Name of Law: Workforce Investment 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:
	80 FR 43796	07/23/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 80816	12/28/2015
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Baseline information forms (BIF) for youth	BIF	Baseline Information Form
Site visit employer protocol
Site visit youth focus group protocol
Site visit master staff protocol

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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	1,769	0	0	1,769	0	0
Annual Time Burden (Hours)	308	0	0	308	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: This information collection supports program evaluation for a new grant program

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Annual Cost to Federal Government: $125,907

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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: 01/12/2016

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