Information Collection

Survey of VAWA-funded Discretionary Grantees about Program Evaluation Practices and Results

IC 237568 under ICR 201905-1122-004 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1122-XXXX Survey of VAWA-funded Discretionary Grantees about Program Evaluation Practices and Results	Form
1122-XXXX OVW Discretionary Grantee Evaluation Survey OVW Discretionary Grantee Evaluation Survey_1032019.docx	Form

IC Title:

Agency IC Tracking Number:

1122-XXXX

Is this a Common Form? No

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	1122-XXXX	OVW Discretionary Grantee Evaluation Survey	OVW Discretionary Grantee Evaluation Survey_1032019.docx		Yes	Yes	Fillable Fileable Signable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,500

Number of Respondents for Small Entity: 3,500

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,500	3,500
Annual IC Time Burden (Hours)	1,750	1,750
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.