Narrative of Changes Table Form 3095

Narrative of Changes Table - DHS Civil Rights Evaluation Tool Updated 2.16.2021.docx

DHS Civil Rights Compliance Form

Narrative of Changes Table Form 3095

OMB: 1601-0024

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Narrative of Changes Table

The purpose of the Narrative of Changes Table is to demonstrate changes to a collection since the previous approval.


Collection Title: DHS Civil Rights Evaluation Tool

OMB Control No.: 1601-0024

Current Expiration Date: 1/31/2021

Collection Instrument(s): DHS Form 3095



Location


Current version

Proposed Revision

Page 1, Section 1:Instructions

Entities selected to receive a grant, cooperative agreement, or other award of Federal financial assistance from the U.S. Department of Homeland Security (DHS) or one of its Components must complete this form and submit required data within thirty (30) days of receipt of the Notice of Award or, for State Administering Agencies, thirty (30) days from receipt of this form from DHS or its awarding component. Recipients are required to provide this information once every two (2) years, not every time a grant is awarded.

Submit the completed form, including supporting materials, to [email protected]. This form clarifies the recipient's civil rights obligations and related reporting requirements contained in the DHS Standard Terms and Conditions.


For recipients who have previously submitted this form in the last two (2) years, if the information provided in response to any of the items below has not changed since the last submission, and there are no additional updates, please indicate “no change” under each applicable item; do not re-submit information previously submitted.


Subrecipients are not required to complete and submit this form to DHS. However, subrecipients have the same obligations as their primary recipients to comply with applicable civil rights requirements and should follow their primary recipient's instructions for

submitting civil rights information to those recipients.


Recipients (as defined in 2 C.F.R. Part 200 and including recipients acting as pass-through entities) of Federal financial assistance from the U.S. Department of Homeland Security (DHS) or one of its awarding component agencies must complete this tool within thirty (30) days of receipt of the Notice of Award for the first award under which this term applies. Recipients of multiple awards of DHS financial assistance should only submit one completed tool for their organization, not per award.

Recipients should submit the completed tool, including supporting materials, to [email protected]. This tool clarifies the civil rights obligations and related reporting requirements contained in the DHS Standard Terms and Conditions.

Subsequent submissions: After the initial submission, recipients are required to complete the tool once every two (2) years if they have an active award, not every time an award is made. After the initial submission, recipients are only required to submit updates. If there are no updates since the initial submission, the recipient can indicate “no change” for each item as applicable to satisfy the biyearly requirement. Recipients should not re-submit information previously submitted. The due date for submitting updates is calculated from two (2) years from the date the recipient last submitted the tool to DHS. DHS will send an email reminder to the contact person identified in Section 2 prior to the due date for the biyearly update.

Subrecipients: Subrecipients are not required to complete and submit this tool to DHS. However, subrecipients have the same obligations as pass-through entities and recipients to comply with applicable civil rights requirements and should follow their pass-through entities’ instructions for submitting civil rights information to those entities.

Extensions: The DHS Office for Civil Rights and Civil Liberties will consider, in its discretion, granting an extension if the recipient identifies steps and a timeline for completing the tool. Recipients should request extensions by emailing the request to [email protected] prior to expiration of the 30-day deadline.


Page 1, Section 2: Organization Informaton

Unique Entity Identifier

DUNS Number


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleNarrative of Revisions
Authortyrone.huff
File Modified0000-00-00
File Created2023-08-17

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