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Commuunity-Based Child Abuse Prevention Program-Application
Community-Based Child Abuse Prevention Program
OMB: 0970-0155
IC ID: 185462
OMB.report
HHS/ACF
OMB 0970-0155
ICR 202411-0970-011
IC 185462
( )
Documents and Forms
Document Name
Document Type
CBCAP Application_General Template_final.docx
Instruction
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 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 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 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:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Instruction
CBCAP Application_General Template_final.docx
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 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
52
0
0
0
0
52
Annual IC Time Burden (Hours)
2,080
0
0
0
0
2,080
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachment 1: CBCAP Conceptual Framework
PI Attachment 1_CBCAP CONCEPTUAL FRAMEWORK.docx
11/19/2024
Attachment 2: Tentative Population Allocation of CBCAP Funds
PI Attachment 2_Tentative Population Allocation of CBCAP Funds.docx
11/19/2024
Attachment 3: Governor’s Assurance Statement
PI Attachment 3. Governors Assurance_with proposed changes_CLEAN.docx
11/19/2024
Attachment 4: State Lead Agency Assurance Statement
PI Attachment 4_State Lead Agency Assurance Statement.docx
11/19/2024
Attachment 5: Leveraged Funds Worksheet with Example Worksheet and Guidance for Differentiation Between Leveraged and Match Funds
PI Attachment 5_Leveraged Funds Worksheet.docx
11/19/2024
Attachment 7: Information and Resources to Promote Collaboration and Coordination with Other Child and Family Support Systems
PI Attachment 7_Information and Resources to Promote Collaboration and Coordination.docx
11/19/2024
Attachment 8: Grants Management Contacts for CBCAP
PI Attachment 8_Grants Management Contacts for CBCAP.docx
11/19/2024
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.