Monitoring and Reporting System for Rape Prevention and Education (RPE) Program Awardees

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Rape Prevention and Education Program Report Tool	Form	Unchanged	Available
Rape Prevention and Education Work PlanTool	Form	Unchanged	Available
Form PRT (Updated) Program Report Tool	Form	Modified	Available
Rape Prevention and Education Program Report Tool	Form	Modified	Available
Form WPT (Updated) Work Plan Tool	Form	Modified	Available
Rape Prevention and Education Work Plan Tool	Form	Modified	Available
Crosswalk of Changes_OMB_No.0920-1130.DOCX	Supplementary Document	Uploaded 2017-03-27	Available
Change_Request_OMB_No.0920-1130.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2017-03-27	Available
Att._5_ IRB-Determination.pdf	Supplementary Document	Uploaded 2016-05-19	Available
Att._2_60-day_FRN_v80_no228.pdf	Supplementary Document	Uploaded 2016-05-19	Available
Att._1c_Legislation_Violence_against_Women_Act.pdf	Supplementary Document	Uploaded 2016-05-19	Available
Att._1b_Legislation_Public_Health_Service_Act_280b.pdf	Supplementary Document	Uploaded 2016-05-19	Available
Att._1a_Legislation_Public_Health_Service_Act_247b.pdf	Supplementary Document	Uploaded 2016-05-19	Available
SSB_MRS_RPE_30Day_041416.docx	Supporting Statement B	Uploaded 2016-05-19	Available
SSA_16BX_30D_ICRO_051616.docx	Supporting Statement A	Uploaded 2016-05-19	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
221590	Program Report Tool - Annual Reporting	Form	Unchanged	Rape Prevention and Education Program Report Tool
221589	Work Plan Tool - Annual Reporting	Form	Unchanged	Rape Prevention and Education Work PlanTool
221588	Program Report Tool - Initial Population	Form	Modified	(Updated) Program Report Tool
221588	Program Report Tool - Initial Population	Form	Modified	Rape Prevention and Education Program Report Tool
221587	Work Plan Tool - Initial Population	Form	Modified	(Updated) Work Plan Tool
221587	Work Plan Tool - Initial Population	Form	Modified	Rape Prevention and Education Work Plan Tool

ICR Details

OMB Control No: 0920-1130	ICR Reference No: 201703-0920-012
Status: Historical Active	Previous ICR Reference No: 201605-0920-009
Agency/Subagency: HHS/CDC	Agency Tracking No: 17AAX
Title: Monitoring and Reporting System for Rape Prevention and Education (RPE) Program Awardees
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/30/2017
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/29/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2019	08/31/2019	08/31/2019
Responses	146	0	146
Time Burden (Hours)	654	0	654
Cost Burden (Dollars)	0	0	0

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Abstract: CDC seeks to collect information from Rape Prevention and Education (RPE) Program awardees related to the implementation, performance and monitoring of the programs per a cooperative agreement.

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Authorizing Statute(s): US Code: 42 USC 247 Name of Law: PHSA
   US Code: 42 USC 13925 Name of Law: Violence Against Women Act
   US Code: 42 USC 280 Name of Law: PHSA
  

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 74108	11/27/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 32329	05/23/2016
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
Program Report Tool - Annual Reporting	none	Rape Prevention and Education Program Report Tool
Program Report Tool - Initial Population	PRT, none	Rape Prevention and Education Program Report Tool ,   (Updated) Program Report Tool
Work Plan Tool - Annual Reporting	none	Rape Prevention and Education Work PlanTool
Work Plan Tool - Initial Population	WPT, none	Rape Prevention and Education Work Plan Tool ,   (Updated) Work Plan Tool

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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	146	146	0	0	0	0
Annual Time Burden (Hours)	654	654	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new ICR.

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Annual Cost to Federal Government: $84,200

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: 03/29/2017

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