Information Collection

Formative Data Collections for American Rescue Plan (ARP) Act Culturally Specific Domestic Violence and Sexual Assault Supplemental Funding Survey

IC 261091 under ICR 202311-0970-014 · OMB 0970-0531.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0531 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
FVPSA ARP Act CSSIRCs ANTRC and NIRC Survey Questions_FINAL CLEAN.docx	Other-survey
FVPSA ARP Act CSSIRCs ANTRC and NIRC Survey Questions_FINAL CLEAN.docx	Other-survey
FVPSA Formative for ACF Program Support - ARP Culturally Specific DV_SA Supp Survey.docx SSA - Formative Data Collections for ARP Act Culturally Specific Domestic Violence and Sexual Assault Supplemental Funding Surve	IC Document
FVPSA Formative for ACF Program Support - ARP Culturally Specific DV_SA Supp Survey.docx SSA - Formative Data Collections for ARP Act Culturally Specific Domestic Violence and Sexual Assault Supplemental Funding Surve	IC Document

IC Title:

Formative Data Collections for American Rescue Plan (ARP) Act Culturally Specific Domestic Violence and Sexual Assault Supplemental Funding Survey

Agency IC Tracking Number:

OFVPS

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-survey			FVPSA ARP Act CSSIRCs ANTRC and NIRC Survey Questions_FINAL CLEAN.docx		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: 145

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	145	145
Annual IC Time Burden (Hours)	145	145
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA - Formative Data Collections for ARP Act Culturally Specific Domestic Violence and Sexual Assault Supplemental Funding Survey	FVPSA Formative for ACF Program Support - ARP Culturally Specific DV_SA Supp Survey.docx	07/14/2023

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.