Information Collection

Commuunity-Based Child Abuse Prevention Program-Application

IC 185462 under ICR 202411-0970-011 · OMB 0970-0155.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
CBCAP Application_General Template_final.docx	Instruction
CBCAP Application_General Template_final.docx	Instruction
PI Attachment 1_CBCAP CONCEPTUAL FRAMEWORK.docx Attachment 1: CBCAP Conceptual Framework	IC Document
PI Attachment 1_CBCAP CONCEPTUAL FRAMEWORK.docx Attachment 1: CBCAP Conceptual Framework	IC Document
PI Attachment 2_Tentative Population Allocation of CBCAP Funds.docx Attachment 2: Tentative Population Allocation of CBCAP Funds	IC Document
PI Attachment 2_Tentative Population Allocation of CBCAP Funds.docx Attachment 2: Tentative Population Allocation of CBCAP Funds	IC Document
PI Attachment 3. Governors Assurance_with proposed changes_CLEAN.docx Attachment 3: Governor’s Assurance Statement	IC Document
PI Attachment 3. Governors Assurance_with proposed changes_CLEAN.docx Attachment 3: Governor’s Assurance Statement	IC Document
PI Attachment 4_State Lead Agency Assurance Statement.docx Attachment 4: State Lead Agency Assurance Statement	IC Document
PI Attachment 4_State Lead Agency Assurance Statement.docx Attachment 4: State Lead Agency Assurance Statement	IC Document
PI Attachment 5_Leveraged Funds Worksheet.docx Attachment 5: Leveraged Funds Worksheet with Example Worksheet and Guidance for Differentiation Between Leveraged and Match Fund	IC Document
PI Attachment 5_Leveraged Funds Worksheet.docx Attachment 5: Leveraged Funds Worksheet with Example Worksheet and Guidance for Differentiation Between Leveraged and Match Fund	IC Document
PI Attachment 7_Information and Resources to Promote Collaboration and Coordination.docx Attachment 7: Information and Resources to Promote Collaboration and Coordination with Other Child and Family Support Systems	IC Document
PI Attachment 7_Information and Resources to Promote Collaboration and Coordination.docx Attachment 7: Information and Resources to Promote Collaboration and Coordination with Other Child and Family Support Systems	IC Document
PI Attachment 8_Grants Management Contacts for CBCAP.docx Attachment 8: Grants Management Contacts for CBCAP	IC Document
PI Attachment 8_Grants Management Contacts for CBCAP.docx Attachment 8: Grants Management Contacts for CBCAP	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Commuunity-Based Child Abuse Prevention Program-Application

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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
Instruction					Yes	Yes	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 52

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	52	52
Annual IC Time Burden (Hours)	2,080	2,080
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment 1: CBCAP Conceptual Framework		11/19/2024
Attachment 2: Tentative Population Allocation of CBCAP Funds		11/19/2024
Attachment 3: Governorâs Assurance Statement		11/19/2024
Attachment 4: State Lead Agency Assurance Statement		11/19/2024
Attachment 5: Leveraged Funds Worksheet with Example Worksheet and Guidance for Differentiation Between Leveraged and Match Funds		11/19/2024
Attachment 7: Information and Resources to Promote Collaboration and Coordination with Other Child and Family Support Systems		11/19/2024
Attachment 8: Grants Management Contacts for CBCAP		11/19/2024

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

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