SIPPRA Outcome Val SIPPRA Outcome Valuation Workbook (Excel)

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Overview

Baseline
After Intervention
Outcome Valuation Calculation
PRA Statement

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Sheet 1: Baseline

OMB No. 1505-0260
Baseline Calculation
	Year 1	Year 2	Year 3	…	Year T	Total
Total Federal Outlays	0	0	0		0	0
Program 1
Program 2
Program 3
⁞
Program P
Total Federal Revenue	0	0	0		0	0
Total Number of Participants	0	0	0		0	0
Total Intervention Cost	0	0	0		0	0
Notes: T is the final year of the intervention period; P is the total number of programs serving the target population

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Sheet 2: After Intervention

OMB No. 1505-0260
Predicted Federal Outlays and Revenue after Program Intervention
	Year 1	Year 2	Year 3	…	Year T	Total
Total Federal Outlays	0	0	0		0	0
Program 1
Program 2
Program 3
⁞
Program P
Total Federal Revenue	0	0	0		0	0
Total Number of Participants	0	0	0		0	0
Total Intervention Cost	0	0	0		0	0
Notes: T is the final year of the intervention period; P is the total number of programs serving the target population

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Sheet 3: Outcome Valuation Calculation

OMB No. 1505-0260
Outcome Valuation
	Year 1	Year 2	Year 3	…	Year T	Total
Total Federal Outlays	0	0	0		0	0
Program 1	0	0	0		0	0
Program 2	0	0	0		0	0
Program 3	0	0	0		0	0
⁞
Program P	0	0	0		0	0
Change in Total Federal Revenue	0	0	0		0	0
Value	0	0	0		0	0
Value per Participant	#DIV/0!	#DIV/0!	#DIV/0!		#DIV/0!	#DIV/0!
Value per Dollar of Intervention Cost	#DIV/0!	#DIV/0!	#DIV/0!		#DIV/0!	#DIV/0!
Total Number of Participants	0	0	0		0	0
Total Intervention Cost	0	0	0		0	0
Maximum Outcome Payment	0
Notes: T is the final year of the intervention period; P is the total number of programs serving the target population

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Sheet 4: PRA Statement

OMB No. 1505-0260

As provided in 5 C.F.R. § 1320.5(b) and § 1320.6(a), an agency may not conduct or sponsor a collection of information unless the collection of information displays a currently valid OMB control number and the agency informs potential persons who are to respond to the collection of information that such persons are not required to respond to the collection of information unless it displays a currently valid OMB control number.