Trafficking Victim Assistance Program Data

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 9 Technical Assistance Form	Form	New	Available
Form 8 Training Form	Form	New	Available
Form 7 Partnership Development Exit form	Form	New	Available
Form 6 Partnership Development Enrollment Form	Form	New	Available
Form 5 TVAP Spending Form	Form	New	Available
Form 4 Barriers to Service Delivery and Monitoring Form	Form	New	Repair queued
Form 3 Client Case Closure Form	Form	New	Available
Form 2 Client Service Use and Delivery Form	Form	New	Available
Form 1 Client Characteristics and Enrollment Form	Form	New	Repair queued
Form 1 Request for Information	Form and Instruction	Removed	Repair queued
Attachment L - OTIP-0499 - TVAP Revision - Grantee Reporting Reference Guide_10.01.19.docx	Supplementary Document	Uploaded 2019-10-02	Repair queued
Attachment B_HRept 114-195 excerpt.pdf	Supplementary Document	Uploaded 2019-10-01	Available
Attachment A_TVPA Chapter 78_ 22 USCA_Excerpts.docx	Supplementary Document	Uploaded 2019-10-01	Available
OTIP-0499 - TVAP Revision - Supporting Statement_10.02.19.doc	Supporting Statement A	Uploaded 2019-10-02	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
237968	Technical Assistance Form	Form	New
237967	Training Form	Form	New
237965	Partnership Development Exit form	Form	New
237964	Partnership Development Enrollment Form	Form	New
237963	TVAP Spending Form	Form	New
237962	Barriers to Service Delivery and Monitoring Form	Form	New
237961	Client Case Closure Form	Form	New
237960	Client Service Use and Delivery Form	Form	New
237959	Client Characteristics and Enrollment Form	Form	New
217869	Request for Information	Form and Instruction	Removed

ICR Details

OMB Control No: 0970-0467	ICR Reference No: 201910-0970-001
Status: Active	Previous ICR Reference No: 201508-0970-009
Agency/Subagency: HHS/ACF	Agency Tracking No: ORR
Title: Trafficking Victim Assistance Program Data
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/06/2020
	Date Received in OIRA: 10/07/2019
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2023	36 Months From Approved
Responses	5,048	0	0
Time Burden (Hours)	2,006	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: This information collection is related to and funded by Trafficking Victim Assistance Program, is authorized by Trafficking Victims Protection Act of 2000 (22 U.S.C. 7105(b)(1)(B)), as amended, and is being conducted by the Office on Trafficking in Persons (OTIP). This is a revised collection. The Trafficking Victim Assistance Program (TVAP) funds grantees to provide comprehensive case management to foreign national victims of human trafficking pursuing HHS Certification with the support of a national network of service providers. OTIP seeks to revise the current information collection to measure grantee progress and performance, improve program evaluation, inform policy, assess program outcomes, and build a response to human trafficking that is responsive to the needs of victims. ACF proposes to collect information from TVAP grant project participants through the grantees on a monthly, quarterly, or annual basis, including participant demographics (age, sex, and country of origin), type of trafficking experienced (sex, labor, or both), enrollment status, types of services and benefits provided, types of health screening and medical services received, the names of the entities providing medical services, the amount of money expended on each type of medical service provided, types of partnerships developed through the grant with subrecipients, and the types of training and technical assistance provided to subrecipient organizations or other partners.

---

Authorizing Statute(s): US Code: 22 USC 7105 Name of Law: Trafficking Victims Protection Act of 2000 (as amended)
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 64580	12/17/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 53446	10/07/2019
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 9

table that charts list of burden

IC Title	Form No.	Form Name
TVAP Spending Form	5	TVAP Spending Form
Training Form	8	Training Form
Technical Assistance Form	9	Technical Assistance Form
Client Characteristics and Enrollment Form	1	Client Characteristics and Enrollment Form
Partnership Development Exit form	7	Partnership Development Exit form
Barriers to Service Delivery and Monitoring Form	4	Barriers to Service Delivery and Monitoring Form
Client Service Use and Delivery Form	2	Client Service Use and Delivery Form
Client Case Closure Form	3	Client Case Closure Form
Partnership Development Enrollment Form	6	Partnership Development Enrollment Form
Request for Information	1	Sample Instrument TVAP data

---

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	5,048	0	0	3,798	0	1,250
Annual Time Burden (Hours)	2,006	0	0	1,693	0	313
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: This is a revised collection under OMB #0970-0467. ACF seeks to request additional information from respondents to measure grantee progress and performance, improve program evaluation, inform policy development, assess program outcomes, and build a response to human trafficking that is responsive to the needs of survivors.

---

Annual Cost to Federal Government: $14,323

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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

---

Common Form ICR:  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:

(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: 10/07/2019

---