83-i

PAPERWORK REDUCTION ACT SUBMISSION
Please read the instructions before completing this form. For additional forms or assistance in completing this form, contact your agency's
Paperwork Clearance Officer. Send two copies of this form, the collection instrument to be reviewed, the Supporting Statement, and any
additional documentation to: Office of Information and Regulatory Affairs, Office of Management and Budget,
Docket Library, Room 10102, 725 17th Street NW, Washington, DC 20503.
2. OMB CONTROL NUMBER

1. AGENCY/SUBAGENCY ORIGINATING REQUEST

OJJDP/OJJDP's NTTAC
a.

1121

0277

b. NONE

4. TYPE OF REVIEW REQUESTED (X one)

3. TYPE OF INFORMATION COLLECTION (X one)
(For b. - f., note Item A2 of Supporting Statement instructions)

a. REGULAR SUBMISSION

a. NEW COLLECTION

b. EMERGENCY - APPROVAL REQUESTED BY:

b. REVISION OF A CURRENTLY APPROVED COLLECTION

c. DELEGATED

c. EXTENSION OF A CURRENTLY APPROVED COLLECTION
d. REINSTATEMENT, WITHOUT CHANGE, OF A PREVIOUSLY
APPROVED COLLECTION FOR WHICH APPROVAL HAS EXPIRED

5. SMALL ENTITIES
Will this information collection have a significant economic
impact on a substantial number of small entities?

e. REINSTATEMENT, WITH CHANGE, OF A PREVIOUSLY
APPROVED COLLECTION FOR WHICH APPROVAL HAS EXPIRED

6. REQUESTED EXPIRATION DATE

YES

NO

a. THREE YEARS FROM APPROVAL DATE

f. EXISTING COLLECTION IN USE WITHOUT AN OMB CONTROL
NUMBER

b. OTHER:

7. TITLE

OJJDP's NTTAC Feedback Form Package
8. AGENCY FORM NUMBER(S) (if applicable)

n/a
9. KEYWORDS

technical assistance, training programs, juvenile justice
10. ABSTRACT

The collection is designed to continuously assess the satisfaction and outcomes of assistance provided through OJJDP's NTTAC for both
monitoring and accountability purposes to continuously meet the needs of the juvenile justice field. OJJDP's NTTAC will give these forms to
recipients of training and technical assistance, OJJDP grantees, users of the help desk, training agencies requesting services, and other professionals
receiving services.
12. OBLIGATION TO RESPOND (X one)

11. AFFECTED PUBLIC (Mark primary with "P" and all others that apply with "X")

P
X
X

a. INDIVIDUALS OR HOUSEHOLDS
b. BUSINESS OR OTHER FOR-PROFIT
c. NOT-FOR-PROFIT INSTITUTIONS

X
X

d. FARMS

a. VOLUNTARY

e. FEDERAL GOVERNMENT

b. REQUIRED TO OBTAIN OR RETAIN BENEFITS

f. STATE, LOCAL OR TRIBAL GOVERNMENT

c. MANDATORY

13. ANNUAL REPORTING AND RECORDKEEPING HOUR BURDEN
a. NUMBER OF RESPONDENTS
b. TOTAL ANNUAL RESPONSES
(1) Percentage of these responses collected electronically
c. TOTAL ANNUAL HOURS REQUESTED
d. CURRENT OMB INVENTORY
e. DIFFERENCE (+, -)
f.

EXPLANATION OF
DIFFERENCE:

14. ANNUALIZED COST TO RESPONDENTS (In thousands of dollars)

5,066
5,066
86.00 %
521
545
-24.5
-

(2) Adustment (+, -)

15. PURPOSE OF INFORMATION COLLECTION (Mark primary with
"P" and all others that apply with "X")

X

c. TOTAL ANNUALIZED COST REQUESTED
d. CURRENT OMB INVENTORY

c. GENERAL PURPOSE STATISTICS
d. AUDIT

17. STATISTICAL METHODS
Does this information collection employ
statistical methods?

f.

OMB FORM 83-I, 10/95

NO

$1,303.02
16,659.02
17,962.04
22,348.00
4,385.96

EXPLANATION OF DIFFERENCE:

e. PROGRAM PLANNING
OR MANAGEMENT
f. RESEARCH
g. REGULATORY OR
COMPLIANCE

-

(2) Adustment (+, -)

16. FREQUENCY OF RECORDKEEPING OR REPORTING (X all that apply)
b. THIRD PARTY DISCLOSURE

c. REPORTING:
(1) On Occasion

(2) Weekly

(3) Monthly

(4) Quarterly

(5) Semi-Annually

(6) Annually

(7) Biennially

(8) Other (Describe) individual events

18. AGENCY CONTACT (Person who can best answer questions regarding the content of this
submission)
a. NAME (Last, First, Middle Initial)

Molter, Jill
YES

-

e. DIFFERENCE (+, -)

a. RECORDKEEPING

P

b. PROGRAM EVALUATION

b. TOTAL ANNUAL COSTS (O&M)

(1) Program change (+, -)

(1) Program change (+, -)

a. APPLICATION FOR BENEFITS

a. TOTAL CAPITAL/STARTUP COSTS

Jill Molter

Digitally signed by Jill Molter
Date: 2021.07.22 10:06:38 -04'00'

b. TELEPHONE NUMBER (Include
area code)

(202) 514-8871
Adobe Professional 8.0

OMB CONTROL NUMBER

1121

0277

TITLE

OJJDP's NTTAC Feedback Form Package

19. CERTIFICATION FOR PAPERWORK REDUCTION ACT SUBMISSIONS
a. PROGRAM OFFICIAL CERTIFICATION (Internal DoD Use Only)
(1) Signature

(2) Date

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies
with 5 CFR 1320.9.
NOTE: The text of 5 CFR 1320.9, and the related provisions of 5 CFR 1320.8(b)(3), appear at the end of the
instructions. The certification is to be made with reference to those regulatory provisions as set forth in the
instructions.
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 (see note in Item 19 of the instructions);
(i) If applicable, it uses effective and efficient statistical survey methodology; and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item below and explain the reason in
Item 18 of the Supporting Statement.

b. SENIOR OFFICIAL OR DESIGNEE CERTIFICATION
(1) Signature

Chyrl Jones
OMB FORM 83-I (BACK), 10/95

(2) Date

Digitally signed by Chyrl Jones
Date: 2021.07.22 11:35:50 -04'00'
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