Faith-Based Neighborhoods

ICR 201603-1895-001

OMB: 1895-0001

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supporting Statement A
2016-04-01
IC Document Collections
IC ID
Document
Title
Status
217801 Modified
ICR Details
1895-0001 201603-1895-001
Historical Active 201508-1895-001
ED/OUS
Faith-Based Neighborhoods
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 05/12/2016
Retrieve Notice of Action (NOA) 04/04/2016
  Inventory as of this Action Requested Previously Approved
05/31/2019 36 Months From Approved
542,829 0 0
19,163 0 0
0 0 0

This is a new information collection necessitated by Executive Order 13559 (the "Executive Order"), Fundamental Principles and Policymaking Criteria for Partnerships with Faith-Based and Other Neighborhood Organizations.The information collected under these new requirements will serve the purpose of notifying beneficiaries of their rights when receiving program services under a program of the Department from a faith-based organization, including the right, established under the Executive Order, to request a referral to a non-faith based provider of services, and requiring faith-based grantees, subgrantees, and contractors that provide program services to make reasonable efforts to refer beneficiaries to another provider, when requested.

EO: EO 13559 Name/Subject of EO: Fundamental Principles and Policymaking Criteria for Partnerships with Fath-Based and Neighborhood
  
None

1895-AA01 Final or interim final rulemaking 81 FR 19355 04/04/2016

No

1
IC Title Form No. Form Name
Faith-Based Neighborhoods N/A Beneficiary Rights and Referral

  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 542,829 0 0 542,829 0 0
Annual Time Burden (Hours) 19,163 0 0 19,163 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Changing Regulations
No
This is a new information collection. This results in a program increase of 542,829 responses and 19,163 hours.

No
No
No
No
No
Uncollected
Peter Wathen-Dunn 202 401-6697 [email protected]

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
04/04/2016


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