Program Impact Evaluations (Level 3 Evaluations)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1190-0021 Facilitator Interview	Form and Instruction	New	Available
Form 1190-0021 Facilitator Interview	Form and Instruction	New	Repair queued
Form 1190-0021 Fidelity Log	Form and Instruction	New	Available
Form 1190-0021 Fidelity Log	Form and Instruction	New	Repair queued
Form 1190-0021 Council Interview	Form and Instruction	New	Available
Form 1190-0021 Council Interview	Form and Instruction	New	Repair queued
Form 1190-0021 Participant Surveyt	Form and Instruction	New	Available
Form 1190-0021 Participant Interview	Form and Instruction	New	Repair queued
Form 1190-0021 Participant Survey	Form and Instruction	New	Available
Form 1190-0021 Participant Survey	Form and Instruction	New	Repair queued
1190_0021_CRS_L3_Non substantive change justification_Jan 2025.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-04-28	Available
1190_0021_CRS_L3_Non substantive change justification_Jan 2025.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-04-28	Repair queued
1190-0021_CRS_L3_Supporting Statement Part A_updated burden_Feb.2025.docx	Supplementary Document	Uploaded 2025-04-28	Available
1190-0021_CRS_L3_Supporting Statement Part A_updated burden_Feb.2025.docx	Supplementary Document	Uploaded 2025-04-28	Repair queued
1190-0021_CRS_Supporting Statement Part A 2024.docx	Supporting Statement A	Uploaded 2024-02-29	Available
1190-0021_CRS_Supporting Statement Part A 2024.docx	Supporting Statement A	Uploaded 2024-02-29	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
275080	Facilitator Interview	Form and Instruction	New	Facilitator Interview
275080	Facilitator Interview	Form and Instruction	New
275079	Fidelity Log	Form and Instruction	New	Fidelity Log
275079	Fidelity Log	Form and Instruction	New
275078	Council Interview	Form and Instruction	New	Council Interview
275078	Council Interview	Form and Instruction	New
275077	Participant Interview	Form and Instruction	New	Participant Surveyt
275077	Participant Interview	Form and Instruction	New
275076	Participant Survey	Form and Instruction	New	Participant Survey
275076	Participant Survey	Form and Instruction	New
265676	L3 Evaluations Interview	Other-Interview	Removed
265675	L3 Evaluations	Other-case study template	Removed

ICR Details

OMB Control No: 1190-0021	ICR Reference No: 202504-1190-001
Status: Active	Previous ICR Reference No: 202402-1190-001
Agency/Subagency: DOJ/CRT	Agency Tracking No: 1190-NEW
Title: Program Impact Evaluations (Level 3 Evaluations)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/12/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 04/28/2025
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2028	01/31/2028	01/31/2028
Responses	950	0	90
Time Burden (Hours)	515	0	90
Cost Burden (Dollars)	519,244	0	0

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Abstract: Over the next three years, CRS anticipates collecting program impact evaluation data for reassessing ongoing programs across several areas within community outreach. The purpose of these collections is to gather feedback from participants who attended CRS programs and to use that information to measure the impact of the programs. This work may entail redesigning and/or modifying existing programs based upon received feedback. CRS envisions using surveys, interviews, and other electronic data collection instruments.

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Authorizing Statute(s): None

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:
	88 FR 88114	12/20/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 14719	02/28/2024
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

table that charts list of burden

IC Title	Form No.	Form Name
Council Interview	1190-0021	Council Interview
Facilitator Interview	1190-0021	Facilitator Interview
Fidelity Log	1190-0021	Fidelity Log
L3 Evaluations
L3 Evaluations Interview
Participant Interview	1190-0021	Participant Surveyt
Participant Survey	1190-0021	Participant Survey

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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	950	90	0	860	0	0
Annual Time Burden (Hours)	515	90	0	425	0	0
Annual Cost Burden (Dollars)	519,244	0	0	519,244	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: CRS estimates that approximately 1,227 respondents will be involved in the information collection conducted under this clearance per year. The average response time per respondent will be up to 1 hour in the form of an interview or up to 15 minutes in the form of an online survey. The estimated total hours spent per interview is 1 hour per interview or 15 minutes for the online survey. If all participants choose to complete the survey, then the estimated number of respondent burden hours is 238 hours for 950 people per year.

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Annual Cost to Federal Government: $519,244

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.     No

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: 04/28/2025

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