Information Collection

Certification with the Statutory Eligibility Requirements of the Violence Against Women Act as Amended and the Prison Rape Elimination Act for the STOPFormula Grant Program

IC 211666 under ICR 201511-1122-004 · OMB 1122-0029.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1122-0029 can be found here:

Documents and Forms

Document Name Document Type
Form 1122-XXXX Certification with the Statutory Eligibility Requirements of the Violence Against Women Act as Amended and the Prison Rape Elimination Act for the STOPFormula Grant Program Form and Instruction
1122-XXXX Certification of Compliance with the Statutory Eligibili Copy of Copy of Copy of DRAFT_UPDATED PREA Form_2 10 2014_1531.xlsx www.usdoj.gov/ovw Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Certification with the Statutory Eligibility Requirements of the Violence Against Women Act as Amended and the Prison Rape Elimination Act for the STOPFormula Grant Program	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1122-XXXX	Certification of Compliance with the Statutory Eligibility Requirements of the Violence Against	Copy of Copy of Copy of DRAFT_UPDATED PREA Form_2 10 2014_1531.xlsx	www.usdoj.gov/ovw	Yes	Yes	Fillable Fileable Signable

Line of Business: Law Enforcement

Subfunction: Crime Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 56	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	56	56
Annual IC Time Burden (Hours)	48	48
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.