Information Collection Request

Domestic Victims of Human Trafficking (DVHT) Program Data

ICR 202310-0970-012 · OMB 0970-0542 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 5 Victim Outreach Form Form Modified Available
Form 6 Training Form Form Removed Available
Form 7 Subrecipient Enrollment Form Modified Available
Form 8 Categories of Assistance Form Modified Available
Form 3 Barriers to Service Delivery and Monitoring Form Form Modified Available
Form 2 Client Case Closure Form Form Modified Available
Form 4 Client Service Use and Delivery Form Form Modified Available
Form 1 Client Characteristics and Program Entry Form Form Modified Available
NonSub Change Request_DVHT_10.26.23.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-10-26 Available
30-Day Public Comment Period OTIP Response_11.29.22_DVHT.docx Supplementary Document Uploaded 2022-11-30 Available
OMB 0970-0542_DVHT Summary of Proposed Changes_9.30.22.docx Supplementary Document Uploaded 2022-10-19 Available
OMB 0970-0542_DVHT Subrecipient Definitions ATIMS.docx Supplementary Document Uploaded 2022-10-19 Available
OMB 0970-0542_DVHT Client Definitions ATIMS.docx Supplementary Document Uploaded 2022-10-19 Available
OMB 0970-0542_Revised DVHT Reporting Reference Guide_10.17.22.docx Supplementary Document Uploaded 2022-10-19 Repair queued
OMB 0970-0542_SSA_10.26.23_Clean.docx Supporting Statement A Uploaded 2023-10-26 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
239409 Victim Outreach Form ModifiedVictim Outreach Form
239409 Victim Outreach Instruction Modified
239408 Training Form RemovedTraining Form
239408 Training Instruction Removed
239406 Subrecipient Enrollment Form ModifiedSubrecipient Enrollment
239406 Subrecipient Enrollment Instruction Modified
239405 Categories of Assistance Form ModifiedCategories of Assistance
239405 Categories of Assistance Instruction Modified
239404 Barriers to Service Delivery and Monitoring Form ModifiedBarriers to Service Delivery and Monitoring Form
239404 Barriers to Service Delivery and Monitoring Instruction Modified
239402 Client Case Closure Form ModifiedClient Case Closure Form
239402 Client Case Closure Instruction Modified
239401 Client Service Use and Delivery Form ModifiedClient Service Use and Delivery Form
239401 Client Service Use and Delivery Instruction Modified
239400 Client Characteristics and Program Entry Form ModifiedClient Characteristics and Program Entry Form
239400 Client Characteristics and Program Entry Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
02/28/2026 02/28/2026 02/28/2026
1,842 0 1,889
699 0 722
0 0 0





Reginfo record details
7
table that charts list of burden
IC Title Form No. Form Name
Barriers to Service Delivery and Monitoring 3
Categories of Assistance 8
Client Case Closure 2
Client Characteristics and Program Entry 1
Client Service Use and Delivery 4
Subrecipient Enrollment 7
Training 6
Victim Outreach 5

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 1,842 1,889 0 -47 0 0
Annual Time Burden (Hours) 699 722 0 -23 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No