Request for Certification of Adult Victims of Human Trafficking

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Request for Certification of Foreign National Adult Victims of Human Trafficking	Form	Modified	Available
Form 1 Request for Certification of Foreign National Adult Victims of Human Trafficking	Form	Modified	Repair queued
FNUSA Comment on Proposed Adult Certification Form Modifications 2025.pdf	Public Comments	Uploaded 2025-05-29	Available
RFC SSA_3.14.25_Clean_final.docx	Supporting Statement A	Uploaded 2025-04-11	Available
RFC SSA_3.14.25_Clean_final.docx	Supporting Statement A	Uploaded 2025-04-11	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
215217	Request for Certification of Foreign National Adult Victims of Human Trafficking	Form	Modified	Request for Certification of Foreign National Adult Victims of Human Trafficking
215217	Request for Certification of Foreign National Adult Victims of Human Trafficking	Form	Modified
215217	Request for Certification of Foreign National Adult Victims of Human Trafficking	Instruction	Modified

ICR Details

OMB Control No: 0970-0454	ICR Reference No: 202504-0970-008
Status: Active	Previous ICR Reference No: 202502-0970-020
Agency/Subagency: HHS/ACF	Agency Tracking No: OTIP
Title: Request for Certification of Adult Victims of Human Trafficking
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/09/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 04/30/2025
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2028	36 Months From Approved	06/30/2025
Responses	623	0	433
Time Burden (Hours)	624	0	433
Cost Burden (Dollars)	0	0	0

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Abstract: The U.S. Department of Health and Human Services (HHS) provides letters of certification to foreign national victims of severe forms of trafficking in persons under the authority of the Trafficking Victims Protection Act of 2000 (TVPA), as amended 22 U.S.C. Section 7105(b)(1)(C) and (E). HHS delegated this authority to the Administration for Children and Families (ACF) Office of Trafficking in Persons (OTIP). OTIP developed a form for potential victims and their advocates, including case managers, attorneys, law enforcement officers, service providers, and other representatives to provide the required information for certification to HHS in accordance with the TVPA of 2000, as amended. The information provided through the completion of the RFC form is essential for OTIP to fulfill its mandate in accordance with the TVPA of 2000, as amended and to issue Certification Letters to eligible foreign national adults. Without a form, OTIP would be limited to notifying potential requesters about the assistance the law permits and providing a phone number or email address at OTIP for further information. An OTIP Case Specialist would then have to describe to each potential requester the information sought in the form, which would likely require multiple follow-up calls and ultimately delay assistance.

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Authorizing Statute(s): US Code: 22 USC 7105 Name of Law: Trafficking Victims Protection Act of 2000, as amended
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 97622	12/09/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 17824	04/29/2025
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Request for Certification of Foreign National Adult Victims of Human Trafficking	1	Request for Certification of Foreign National Adult Victims of Human Trafficking

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ICR Summary of Burden

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	623	433	0	190	0	0
Annual Time Burden (Hours)	624	433	0	191	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: OTIP continuously monitors the RFCs received and certification letters issued. The fluctuation in certification letters primarily reflects changing patterns in law enforcement investigations by DHS. In FY 2024, ACF issued 466 certification letters, a 15 percent decrease from FY 2023. Burden estimates have been calculated based on the average number of RFCs received and certification letters issued over the last two periods that the information collection has been in effect (Fiscal Year 2019 to 2024), where OTIP received approximately 8 to 12 RFCs per week (416 to 624 RFCs per year) and issued an average of 525 certification letters per year. The time to complete the RFC remains the same and no changes are proposed.

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Annual Cost to Federal Government: $72,465

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 04/30/2025

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