Information Collection

Request for Assistance for Child Victims of Human Trafficking

IC 188787 under ICR 202107-0970-002 · OMB 0970-0362.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0362 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Request for Assistance for Child Victims of Human Trafficking Form
Proposed RFA Instructions for Shepherd Webform.pdf Instruction
Proposed RFA Instructions for Shepherd Webform.pdf Instruction
1 RFA Draft Proposed RFA Final_6.30.21_Final.pdf Form
1 RFA Draft Proposed RFA Final_8.6.21.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Request for Assistance for Child Victims of Human Trafficking	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	RFA Draft	Proposed RFA Final_8.6.21.pdf		Yes	Yes	Fillable Printable
Instruction			Proposed RFA Instructions for Shepherd Webform.pdf		Yes	Yes	Printable Only

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,600	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,200	400	800
Annual IC Time Burden (Hours)	1,200	400	800
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.