Information Collection

Family Violence Prevention and Services Program

IC 220701 under ICR 201602-0970-008 · OMB 0970-0476.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0476 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Family Violence Prevention and Services Program	Form and Instruction
1 FVPSP DICP FVPSP DICP for OMB 21 MAR 2016.docx	Form and Instruction
FVPSP Disaster Information Collection Form 21 MAR 2016.doc FVPSP	IC Document

IC Title:

Family Violence Prevention and Services Program

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

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 and Instruction	1	FVPSP DICP	FVPSP DICP for OMB 21 MAR 2016.docx		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	10	10
Annual IC Time Burden (Hours)	10	10
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
FVPSP	FVPSP Disaster Information Collection Form 21 MAR 2016.doc	03/21/2016

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