Generic Performance Progress Reports

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 MLP + Quantitative Semi-Annual Report	Form	Unchanged	Available
Form 1 Medical-Legal Partnerships Semi-Annual Quantitative Report	Form	Unchanged	Repair queued
Form 1 PDG B-5 Renewal Grant APPR	Form and Instruction	Unchanged	Repair queued
Form 1 Preschool Development Grant Birth through Five (PDG B-5) Renewal Grant Annual Performance Progress Report –2025 Revision	Form and Instruction	Unchanged	Repair queued
Form 1 CED-P PPR	Form and Instruction	Unchanged	Repair queued
Form 1 Community Economic Development – Planning (CED-P) Grant Recipient Performance Progress Report (PPR)	Form and Instruction	Unchanged	Repair queued
Form 1 STAR Program Data Point Form	Form	Unchanged	Available
Form 1 DDDRP PPR	Form and Instruction	Unchanged	Available
Form 1 Diaper Distribution Demonstration and Research Pilot Quarterly Reporting Requirements	Form and Instruction	Unchanged	Repair queued
Form 1 CSDVSA PPR	Form and Instruction	Modified	Available
Form 1 Family Violence Prevention and Services: Grants to support Culturally Specific Domestic Violence and Sexual Assault (CSDVSA) Programs	Form and Instruction	Modified	Repair queued
Form 1 SSAPC PPR	Form and Instruction	Unchanged	Available
Form 1 Family Violence Prevention and Services: Grants to support Specialized Services for Abused Parents and Children (SSAPC)	Form and Instruction	Unchanged	Repair queued
Form 1 FVPSA PPR - National Domestic Violence Hotline	Form and Instruction	Unchanged	Available
Form 1 Family Violence Prevention and Services: Grants to the National Domestic Violence Hotline	Form and Instruction	Unchanged	Repair queued
Form 1 Resource Center Performance Progress Report	Form and Instruction	Unchanged	Available
Form 1 Family Violence Prevention and Services: National, Special Issue, and Culturally Specific Resource Centers	Form and Instruction	Unchanged	Repair queued
Form B-01 RPG Program SAPR	Form and Instruction	Unchanged	Available
Form B-01a RPG Program SAPR Attachment	Form and Instruction	Unchanged	Available
Form B-01a Regional Partnership Grant Program Semi Annual ACF Performance Progress Report	Form and Instruction	Unchanged	Repair queued
Form 1 HS-PRS PPR Data Collection Template	Form	Unchanged	Available
Form 1 SASIC Data Point Form	Form	Unchanged	Repair queued
Form Part B Wilson Fish TANF Coordination Project Performance Report Part B	Form	Unchanged	Available
Form Part A Wilson Fish TANF Coordination Project Performance Report Part A	Form	Unchanged	Available
Form Part A Wilson-Fish TANF Coordination Project Performance Report Part A and B	Form	Unchanged	Repair queued
Form 4 Tribal MIECHV Quarterly Performance Reporting Form	Form	Unchanged	Available
Form 4 Tribal Maternal, Infant, and Early Childhood Home Visiting Program Form 4: Quarterly Performance Reporting Form	Form	Unchanged	Available
Form 1 RCP Program Performance Data	Form	Unchanged	Repair queued
Form 1 IDA Program Indicators	Form	Unchanged	Available
Form 1 RAPP Indicators	Form	Unchanged	Available
Form 1 RFCCMED Performance Data	Form	Unchanged	Available
Form 1 MED Program Indicators	Form	Unchanged	Available
Form 1 HSCO Annual Report	Form and Instruction	Unchanged	Available
Form 1 Head Start Collaboration Office Annual Report	Form and Instruction	Unchanged	Repair queued
Form 1 ECSH Reporting Form	Form	Unchanged	Repair queued
Form 1 Community Collaborations to Strengthen and Preserve Families Semiannual ACF Performance Progress Report; Appendix B - Program Indicators	Form and Instruction	Unchanged	Repair queued
Form 1 Community Collaborations to Strengthen and Preserve Families Semi Annual ACF Performance Progress Report	Form and Instruction	Unchanged	Repair queued
Form 2 ARP EL Post Project Report	Form	Unchanged	Repair queued
Form 1 ARP EL Progress Report	Form	Unchanged	Repair queued
Form 1 Administration for Native Americans (ANA) American Rescue Plan Emergency Language (ARP EL) Progress Report and Post Project Report	Form	Unchanged	Repair queued
OFVPS CSDVSA PPR GenIC Change Request_12.9.25.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-12-09	Available
OFVPS CSDVSA PPR GenIC Change Request_12.9.25.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-12-09	Repair queued
Change Request - PPR GenIC_ORR Ref MED PI Instructions_0970-0490_11.19.25.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-11-19	Available
Change Request - PPR GenIC_ORR Ref MED PI Instructions_0970-0490_11.19.25.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-11-19	Repair queued
NonSub Change Request - MLP PPR_9.25.25.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-09-25	Available
NonSub Change Request - MLP PPR_9.25.25.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-09-25	Repair queued
STAR_Change Request for GenICs_842025.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-08-06	Available
STAR_Change Request for GenICs_842025.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-08-06	Available
Change Request_RPG SAPR_PPR GenIC_0970-0490_7.31.25.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-08-04	Available
Change Request_RPG SAPR_PPR GenIC_0970-0490_7.31.25.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-08-04	Repair queued
NonSub Change_CCWC PPR GenIC_DEI EO Update_0970-0490_7.25.25.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-07-25	Available
NonSub Change_CCWC PPR GenIC_DEI EO Update_0970-0490_7.25.25.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-07-25	Repair queued
Change Request memo_PDG-B APPR revision_New IC Line_0970-0490_July 2025.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-07-21	Repair queued
Change Request memo_PDG-B APPR revision_New IC Line_0970-0490_July 2025.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-07-21	Repair queued
NonSub Change_Update to ACF ICs_Protecting Women EO_0970-0490_June 2025.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-06-10	Available
NonSub Change_Update to ACF ICs_Protecting Women EO_0970-0490_June 2025.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-06-10	Repair queued
NonSub Change - Update to ACF ICs - Protecting Women EO - Submission 2.10.25.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-02-10	Available
NonSub Change - Update to ACF ICs - Protecting Women EO - Submission 2.10.25.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-02-10	Repair queued
CED-P PPR 0970-0490 NonSub Change Request.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-02-10	Available
CED-P PPR 0970-0490 NonSub Change Request.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-02-10	Repair queued
DDDRP PPR 0970-0490 NonSub Change Request.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-02-10	Available
DDDRP PPR 0970-0490 NonSub Change Request.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-02-10	Repair queued
DDDRP PPR_Change Request_Oct 2024.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-10-11	Available
DDDRP PPR_Change Request_Oct 2024.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-10-11	Repair queued
Change Request for DDDRP PPR.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-04-12	Available
Change Request for DDDRP PPR.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-04-12	Repair queued
Submission Form - ECSH GenIC Jan 2024 update.CLEAN.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-01-24	Available
Submission Form - ECSH GenIC Jan 2024 update.CLEAN.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-01-24	Repair queued
Change Request HSCO Annual Report (12-23)_cln.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2023-12-18	Available
Change Request HSCO Annual Report (12-23)_cln.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2023-12-18	Repair queued
NonSub Change Reques_ORR SASIC User Guide_11.20.23.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2023-11-20	Available
NonSub Change Reques_ORR SASIC User Guide_11.20.23.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2023-11-20	Repair queued
Change Request memo_APPR revision_4.27.23_fnl.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2023-05-15	Available
Change Request memo_APPR revision_4.27.23_fnl.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2023-05-15	Repair queued
SSA - ACF Generic PPR - Renewal 2022_final 2023.docx	Supporting Statement A	Uploaded 2023-01-25	Available
SSA - ACF Generic PPR - Renewal 2022_final 2023.docx	Supporting Statement A	Uploaded 2023-01-25	Repair queued
Attachment B - ACF OGM PPR Word version_updated exp date 2026 clean.docx	Supplementary Document	Uploaded 2023-01-26	Available
Attachment B - ACF OGM PPR Word version_updated exp date 2026 clean.docx	Supplementary Document	Uploaded 2023-01-26	Repair queued
Attachment A - Submission Template ACF Generic PPR 0970-0490.docx	Supplementary Document	Uploaded 2023-01-26	Available
Attachment A - Submission Template ACF Generic PPR 0970-0490.docx	Supplementary Document	Uploaded 2023-01-26	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
277392	Medical-Legal Partnerships Semi-Annual Quantitative Report	Form	Unchanged	MLP + Quantitative Semi-Annual Report
277392	Medical-Legal Partnerships Semi-Annual Quantitative Report	Form	Unchanged
276522	Preschool Development Grant Birth through Five (PDG B-5) Renewal Grant Annual Performance Progress Report –2025 Revision	Form and Instruction	Unchanged	PDG B-5 Renewal Grant APPR
276522	Preschool Development Grant Birth through Five (PDG B-5) Renewal Grant Annual Performance Progress Report –2025 Revision	Form and Instruction	Unchanged
272310	Community Economic Development – Planning (CED-P) Grant Recipient Performance Progress Report (PPR)	Form and Instruction	Unchanged	CED-P PPR
272310	Community Economic Development – Planning (CED-P) Grant Recipient Performance Progress Report (PPR)	Form and Instruction	Unchanged
271926	Support for Trauma-Affected Refugees (STAR) Annual Program Data Points (PDP) Tool and User Guide	Form	Unchanged	STAR Program Data Point Form
271926	Support for Trauma-Affected Refugees (STAR) Annual Program Data Points (PDP) Tool and User Guide	Instruction	Unchanged
271507	Diaper Distribution Demonstration and Research Pilot Quarterly Reporting Requirements	Form and Instruction	Unchanged	DDDRP PPR
271507	Diaper Distribution Demonstration and Research Pilot Quarterly Reporting Requirements	Form and Instruction	Unchanged
270280	Family Violence Prevention and Services: Grants to support Culturally Specific Domestic Violence and Sexual Assault (CSDVSA) Programs	Form and Instruction	Modified	CSDVSA PPR
270280	Family Violence Prevention and Services: Grants to support Culturally Specific Domestic Violence and Sexual Assault (CSDVSA) Programs	Form and Instruction	Modified
270279	Family Violence Prevention and Services: Grants to support Specialized Services for Abused Parents and Children (SSAPC)	Form and Instruction	Unchanged	SSAPC PPR
270279	Family Violence Prevention and Services: Grants to support Specialized Services for Abused Parents and Children (SSAPC)	Form and Instruction	Unchanged
267422	Family Violence Prevention and Services: Grants to the National Domestic Violence Hotline	Form and Instruction	Unchanged	FVPSA PPR - National Domestic Violence Hotline
267422	Family Violence Prevention and Services: Grants to the National Domestic Violence Hotline	Form and Instruction	Unchanged
267342	Family Violence Prevention and Services: National, Special Issue, and Culturally Specific Resource Centers	Form and Instruction	Unchanged	Resource Center Performance Progress Report
267342	Family Violence Prevention and Services: National, Special Issue, and Culturally Specific Resource Centers	Form and Instruction	Unchanged
266598	Regional Partnership Grant Program Semi Annual ACF Performance Progress Report	Form and Instruction	Unchanged	RPG Program SAPR
266598	Regional Partnership Grant Program Semi Annual ACF Performance Progress Report	Form and Instruction	Unchanged	RPG Program SAPR Attachment
266598	Regional Partnership Grant Program Semi Annual ACF Performance Progress Report	Form and Instruction	Unchanged
265534	Instructions for the Office of Refugee Resettlement Unaccompanied Children Program Home Study and Post-Release Service Grant Recipient Program Indicators	Form	Unchanged	HS-PRS PPR Data Collection Template
265534	Instructions for the Office of Refugee Resettlement Unaccompanied Children Program Home Study and Post-Release Service Grant Recipient Program Indicators	Instruction	Unchanged
263479	Office of Refugee Resettlement Services to Afghan Survivors of Combat (SASIC) Program Performance Data Point Tool & User Guide	Form	Unchanged	SASIC Data Point Form
263479	Office of Refugee Resettlement Services to Afghan Survivors of Combat (SASIC) Program Performance Data Point Tool & User Guide	Instruction	Unchanged
259372	Employer Engagement Program Performance Data	Instruction	Unchanged
258084	Wilson-Fish TANF Coordination Project Performance Report Part A and B	Form	Unchanged	Wilson Fish TANF Coordination Project Performance Report Part B
258084	Wilson-Fish TANF Coordination Project Performance Report Part A and B	Form	Unchanged	Wilson Fish TANF Coordination Project Performance Report Part A
258084	Wilson-Fish TANF Coordination Project Performance Report Part A and B	Form	Unchanged
258084	Wilson-Fish TANF Coordination Project Performance Report Part A and B	Instruction	Unchanged
258082	Tribal Maternal, Infant, and Early Childhood Home Visiting Program Form 4: Quarterly Performance Reporting Form	Form	Unchanged	Tribal MIECHV Quarterly Performance Reporting Form
258082	Tribal Maternal, Infant, and Early Childhood Home Visiting Program Form 4: Quarterly Performance Reporting Form	Form	Unchanged
258075	Refugee Resettlement Refugee Career Pathways (RCP) Program Performance Data	Form	Unchanged	RCP Program Performance Data
258075	Refugee Resettlement Refugee Career Pathways (RCP) Program Performance Data	Instruction	Unchanged
258074	Refugee Individual Development Accounts (IDA) Program Indicators	Form	Unchanged	IDA Program Indicators
258074	Refugee Individual Development Accounts (IDA) Program Indicators	Instruction	Unchanged
258073	Refugee Agricultural Partnership Program (RAPP) Indicators	Form	Unchanged	RAPP Indicators
258073	Refugee Agricultural Partnership Program (RAPP) Indicators	Instruction	Unchanged
258071	Office of Refugee Resettlement Refugee Family Child Care Microenterprise (RFCCMED) Program Performance Data	Form	Unchanged	RFCCMED Performance Data
258071	Office of Refugee Resettlement Refugee Family Child Care Microenterprise (RFCCMED) Program Performance Data	Instruction	Unchanged
258070	Microenterprise Development (MED) Program Indicators	Form	Unchanged	MED Program Indicators
258070	Microenterprise Development (MED) Program Indicators	Instruction	Unchanged
258069	Human Trafficking Youth Prevention Education (HTYPE) Demonstration Grant Program Performance Indicators	Other-Performance Indicators	Unchanged
258068	Head Start Collaboration Office Annual Report	Form and Instruction	Unchanged	HSCO Annual Report
258068	Head Start Collaboration Office Annual Report	Form and Instruction	Unchanged
258067	Ethnic Community Self-Help (ECSH) Program Data Indicators	Form	Unchanged	ECSH Reporting Form
258067	Ethnic Community Self-Help (ECSH) Program Data Indicators	Instruction	Unchanged
258066	Community Collaborations to Strengthen and Preserve Families Semi Annual ACF Performance Progress Report	Form and Instruction	Unchanged	Community Collaborations to Strengthen and Preserve Families Semiannual ACF Performance Progress Report; Appendix B - Program Indicators
258066	Community Collaborations to Strengthen and Preserve Families Semi Annual ACF Performance Progress Report	Form and Instruction	Unchanged
258060	Administration for Native Americans (ANA) American Rescue Plan Emergency Language (ARP EL) Progress Report and Post Project Report	Form	Unchanged	ARP EL Post Project Report
258060	Administration for Native Americans (ANA) American Rescue Plan Emergency Language (ARP EL) Progress Report and Post Project Report	Form	Unchanged	ARP EL Progress Report
258060	Administration for Native Americans (ANA) American Rescue Plan Emergency Language (ARP EL) Progress Report and Post Project Report	Form	Unchanged
258060	Administration for Native Americans (ANA) American Rescue Plan Emergency Language (ARP EL) Progress Report and Post Project Report	Instruction	Unchanged

ICR Details

OMB Control No: 0970-0490	ICR Reference No: 202512-0970-001
Status: Historical Active	Previous ICR Reference No: 202511-0970-003
Agency/Subagency: HHS/ACF	Agency Tracking No: ACF - All Programs
Title: Generic Performance Progress Reports
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: 12/19/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 12/10/2025
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2026	03/31/2026	03/31/2026
Responses	3,915	0	3,915
Time Burden (Hours)	19,455	0	19,455
Cost Burden (Dollars)	0	0	0

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Abstract: This information collection request (ICR) is for data collection under the Administration for Children and Families (ACF) Generic Program-Specific Performance Progress Report (PPR) (0970-0490). This overarching generic has allowed ACF program offices to collect performance and progress data from recipients who receive funding from ACF under a discretionary award. This information is required under 45 CFR 75.342, monitoring and reporting program performance; 45 CFR 75.301, performance measurement; and the GPRA Modernization Act of 2010 (Pub.L. 111-352, Sec 12).

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Authorizing Statute(s): PL: Pub.L. 111 - 352 12 Name of Law: GPRA Modernization Act of 2010
  

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:
	87 FR 40245	07/06/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 5887	01/30/2023
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 25

table that charts list of burden

IC Title	Form No.	Form Name
Administration for Native Americans (ANA) American Rescue Plan Emergency Language (ARP EL) Progress Report and Post Project Report	1, 2	ARP EL Progress Report ,   ARP EL Post Project Report
Community Collaborations to Strengthen and Preserve Families Semi Annual ACF Performance Progress Report	1	Community Collaborations to Strengthen and Preserve Families Semiannual ACF Performance Progress Report; Appendix B - Program Indicators
Community Economic Development – Planning (CED-P) Grant Recipient Performance Progress Report (PPR)	1	CED-P PPR
Diaper Distribution Demonstration and Research Pilot Quarterly Reporting Requirements	1	DDDRP PPR
Employer Engagement Program Performance Data
Ethnic Community Self-Help (ECSH) Program Data Indicators	1	ECSH Reporting Form
Family Violence Prevention and Services: Grants to support Culturally Specific Domestic Violence and Sexual Assault (CSDVSA) Programs	1	CSDVSA PPR
Family Violence Prevention and Services: Grants to support Specialized Services for Abused Parents and Children (SSAPC)	1	SSAPC PPR
Family Violence Prevention and Services: Grants to the National Domestic Violence Hotline	1	FVPSA PPR - National Domestic Violence Hotline
Family Violence Prevention and Services: National, Special Issue, and Culturally Specific Resource Centers	1	Resource Center Performance Progress Report
Head Start Collaboration Office Annual Report	1	HSCO Annual Report
Human Trafficking Youth Prevention Education (HTYPE) Demonstration Grant Program Performance Indicators
Instructions for the Office of Refugee Resettlement Unaccompanied Children Program Home Study and Post-Release Service Grant Recipient Program Indicators	1	HS-PRS PPR Data Collection Template
Medical-Legal Partnerships Semi-Annual Quantitative Report	1	MLP + Quantitative Semi-Annual Report
Microenterprise Development (MED) Program Indicators	1	MED Program Indicators
Office of Refugee Resettlement Refugee Family Child Care Microenterprise (RFCCMED) Program Performance Data	1	RFCCMED Performance Data
Office of Refugee Resettlement Services to Afghan Survivors of Combat (SASIC) Program Performance Data Point Tool & User Guide	1	SASIC Data Point Form
Preschool Development Grant Birth through Five (PDG B-5) Renewal Grant Annual Performance Progress Report –2025 Revision	1	PDG B-5 Renewal Grant APPR
Refugee Agricultural Partnership Program (RAPP) Indicators	1	RAPP Indicators
Refugee Individual Development Accounts (IDA) Program Indicators	1	IDA Program Indicators
Refugee Resettlement Refugee Career Pathways (RCP) Program Performance Data	1	RCP Program Performance Data
Regional Partnership Grant Program Semi Annual ACF Performance Progress Report	B-01a, B-01	RPG Program SAPR Attachment ,   RPG Program SAPR
Support for Trauma-Affected Refugees (STAR) Annual Program Data Points (PDP) Tool and User Guide	1	STAR Program Data Point Form
Tribal Maternal, Infant, and Early Childhood Home Visiting Program Form 4: Quarterly Performance Reporting Form	4	Tribal MIECHV Quarterly Performance Reporting Form
Wilson-Fish TANF Coordination Project Performance Report Part A and B	Part A, Part B	Wilson Fish TANF Coordination Project Performance Report Part A ,   Wilson Fish TANF Coordination Project Performance Report Part B

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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	3,915	3,915	0	0	0	0
Annual Time Burden (Hours)	19,455	19,455	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: This is a request for an extension to a previously approved collection. Adjustments to burden estimates reflect changes in the currently approved and ongoing GenICs, updates to estimated average number of responses and burden hours per response (based on feedback, experiences to date, and projections for upcoming years) and the broadened scope to include non-discretionary grants. See A12, subsection Previously Approved and Ongoing Information Collections for additional information.

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Annual Cost to Federal Government: $80,117

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: 12/10/2025

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