Evaluation of Family Violence Prevention and Services Act (FVPSA) Regional Meeting

Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0401 can be found here:

Documents and Forms

Document Name Document Type
FVPSA Regional Meeting Evaluation Questions1.docx Other-Survey
FVPSA Evaluation1 - Fast Track Submission Form.doc Fast Track Submission Form - FVPSA Regional Meeting IC Document

Information Collection (IC) Details

IC Title:	Evaluation of Family Violence Prevention and Services Act (FVPSA) Regional Meeting	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey			FVPSA Regional Meeting Evaluation Questions1.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 250	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	63	63
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast Track Submission Form - FVPSA Regional Meeting	FVPSA Evaluation1 - Fast Track Submission Form.doc	05/08/2019

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