Information Collection Request

Domestic Victims of Human Trafficking (DVHT) Program Data

ICR 202509-0970-011 · OMB 0970-0542 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 5b DVHT Reporting Workbook - For Use Only If Recipient Unable to Report in ATIMS Form and Instruction Modified Repair queued
Form 5 Client Outreach Form Form Modified Available
Form 5 Client Outreach Form Modified Repair queued
Form 6b DVHT Reporting Workbook - For Use Only If Recipient Unable to Report in ATIMS Form and Instruction Modified Available
Form 6 Subrecipient Enrollment Form Modified Available
Form 6 Subrecipient Enrollment Form Modified Repair queued
Form 7b DVHT Reporting Workbook - For Use Only If Recipient Unable to Report in ATIMS Form and Instruction Modified Available
Form 7 Client Service Costs Form Modified Available
Form 7 Client Service Costs Form Modified Available
Form 3b DVHT Reporting Workbook - For Use Only If Recipient Unable to Report in ATIMS Form and Instruction Modified Available
Form 3 Barriers to Service Delivery and Monitoring Form Form Modified Repair queued
Form 2b DVHT Reporting Workbook - For Use Only If Recipient Unable to Report in ATIMS Form and Instruction Modified Repair queued
Form 2 Client Case Closure Form Form Modified Repair queued
Form 2 Client Case Closure Form Modified Repair queued
Form 4b Reporting Workbook - For use if unable to report in ATIMS Form and Instruction Modified Available
Form 4 FY25 DVHT Performance Indicators Form Modified Available
Form 4 Client Service Use and Delivery Form Modified Repair queued
Form 1b Reporting Workbook - For use if unable to report in ATIMS Form and Instruction Modified Repair queued
Form 1 FY25 DVHT Performance Indicators Form Modified Available
OMB 0970-0542_SSA_FY25 Renewal_clean.docx Supporting Statement A Uploaded 2025-09-25 Repair queued
OMB 0970-0542_SSA_FY25 Renewal_clean.docx Supporting Statement A Uploaded 2025-09-25 Missing upstream

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
239409 Client Outreach Form and Instruction ModifiedDVHT Reporting Workbook - For Use Only If Recipient Unable to Report in ATIMS
239409 Client Outreach Form ModifiedClient Outreach Form
239409 Client Outreach Form Modified
239409 Client Outreach Instruction Modified
239406 Subrecipient Enrollment Form and Instruction ModifiedDVHT Reporting Workbook - For Use Only If Recipient Unable to Report in ATIMS
239406 Subrecipient Enrollment Form ModifiedSubrecipient Enrollment
239406 Subrecipient Enrollment Form Modified
239406 Subrecipient Enrollment Instruction Modified
239405 Client Service Costs Form and Instruction ModifiedDVHT Reporting Workbook - For Use Only If Recipient Unable to Report in ATIMS
239405 Client Service Costs Form ModifiedClient Service Costs
239405 Client Service Costs Form Modified
239405 Client Service Costs Instruction Modified
239404 Barriers to Service Delivery and Monitoring Form and Instruction ModifiedDVHT Reporting Workbook - For Use Only If Recipient Unable to Report in ATIMS
239404 Barriers to Service Delivery and Monitoring Form ModifiedBarriers to Service Delivery and Monitoring Form
239404 Barriers to Service Delivery and Monitoring Instruction Modified
239402 Client Case Closure Form and Instruction ModifiedDVHT Reporting Workbook - For Use Only If Recipient Unable to Report in ATIMS
239402 Client Case Closure Form ModifiedClient Case Closure Form
239402 Client Case Closure Form Modified
239402 Client Case Closure Instruction Modified
239401 Client Service Use and Delivery Form and Instruction ModifiedReporting Workbook - For use if unable to report in ATIMS
239401 Client Service Use and Delivery Form ModifiedFY25 DVHT Performance Indicators
239401 Client Service Use and Delivery Form Modified
239401 Client Service Use and Delivery Instruction Modified
239400 Client Characteristics and Program Entry Form and Instruction ModifiedReporting Workbook - For use if unable to report in ATIMS
239400 Client Characteristics and Program Entry Form ModifiedFY25 DVHT Performance Indicators
239400 Client Characteristics and Program Entry Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
11/30/2028 36 Months From Approved 02/28/2026
1,041 0 1,842
387 0 699
0 0 0





Reginfo record details
7
table that charts list of burden
IC Title Form No. Form Name
Barriers to Service Delivery and Monitoring 3b, 3 ,  
Client Case Closure 2, 2b ,  
Client Characteristics and Program Entry 1, 1b ,  
Client Outreach 5, 5b ,  
Client Service Costs 7b, 7 ,  
Client Service Use and Delivery 4b, 4 ,  
Subrecipient Enrollment 6, 6b ,  

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 1,041 1,842 0 -801 0 0
Annual Time Burden (Hours) 387 699 0 -312 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No