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Information Collection

Family Violence Prevention and Services Program Disaster Information Collection Form

IC 276119 under ICR 202507-0970-006 · OMB 0970-0476.

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Information Collection (IC) Details

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Family Violence Prevention and Services Program Disaster Information Collection Form OFVPS
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 1 Family Violence Prevention Service Program Disaster Information Collection Form FVPSP Disaster Info Collection Instrument_exp_07312025 (1).docx Yes Yes Fillable Fileable

Community and Social Services Social Services

 

10 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   85 %

  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 10 0 10 0 0 0
Annual IC Time Burden (Hours) 10 0 10 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
GenIC - Family Violence Prevention Service Program Disaster Information Collection Form FVPSP Disaster Info Collection Submission Form.docx 07/02/2025
NOA - Family Violence Prevention Service Program Disaster Information Collection Form NOA_DICP_0970-0476_7.15.22.pdf 07/03/2025
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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