Information Collection

Monitoring

IC 220839 under ICR 202502-1121-001 · OMB 1121-0243.

Documents and Forms

Document Name Document Type
Monitoring Form
Monitoring CMT screen shots (3).pdf Form
Monitoring CMT screen shots (3).pdf Form
Justification for change on OVC Victim Compensation State Certification form 1121.docx Justification IC Document
Justification for change on OVC Victim Compensation State Certification form 1121.docx Justification IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Monitoring	Agency IC Tracking Number:	OAAM

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
Form	none	Monitoring	CMT screen shots (3).pdf	n/a	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,893	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	1,893	1,840	53
Annual IC Time Burden (Hours)	1,893	1,840	53
Annual IC Cost Burden (Dollars)	169,234	164,496	4,738

Documents for IC

Title	Document	Date Uploaded
Justification	Justification for change on OVC Victim Compensation State Certification form 1121.docx	03/23/2017

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