SIPPRA Grant Application, Recordkeeping and Reports

Application, Reports, and Recordkeeping for the Social Impact Partnerships to Pay for Results Act (SIPPRA) grant Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1505-0260 can be found here:

Documents and Forms

Document Name Document Type
SIPPRA NOFA 1-28-19 draft for Supporting Stmt.docx www.grants.gov Other-Notice of Funding Availability
SIPPRA NOFA 1-28-19 draft for Supporting Stmt.docx www.grants.gov Other-Notice of Funding Availability
SIPPRA Outcome Val SIPPRA Outcome Valuation Workbook (word) SIPPRA Outcome Valuation Template 3.7.19 with PRA Statement.docx Form
SIPPRA Outcome Val SIPPRA Outcome Valuation Workbook (word) SIPPRA Outcome Valuation Template 3.7.19 with PRA Statement.docx Form
SIPPRA Outcome Val SIPPRA Outcome Valuation Workbook (Excel) SIPPRA Outcome Valuation Workbook 3.7.19 with PRA Statement.xlsx Form
SIPPRA Outcome Val SIPPRA Outcome Valuation Workbook (Excel) SIPPRA Outcome Valuation Workbook 3.7.19 with PRA Statement.xlsx Form

Information Collection (IC) Details

IC Title:	SIPPRA Grant Application, Recordkeeping and Reports	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

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
Other-Notice of Funding Availability			SIPPRA NOFA 1-28-19 draft for Supporting Stmt.docx	www.grants.gov	Yes	Yes	Fillable Fileable
Form	SIPPRA Outcome Valuation Workbook (word)	SIPPRA Outcome Valuation Workbook (word)	SIPPRA Outcome Valuation Template 3.7.19 with PRA Statement.docx		Yes	Yes	Fillable Fileable
Form	SIPPRA Outcome Valuation Workbook (Excel)	SIPPRA Outcome Valuation Workbook (Excel)	SIPPRA Outcome Valuation Workbook 3.7.19 with PRA Statement.xlsx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	120	120
Annual IC Time Burden (Hours)	2,190	2,190
Annual IC Cost Burden (Dollars)	9,145,000	9,145,000

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.