NOA - Fiscal Responsibility Act TANF Pilot Program 2025 Information Collection

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NOTICE OF OFFICE OF MANAGEMENT AND BUDGET ACTION
Date

07/02/2025

Department of Health and Human Services
Administration for Children and Families
FOR CERTIFYING OFFICIAL:

Kevin Duvall

FOR CLEARANCE OFFICER:

Catherine Howard

In accordance with the Paperwork Reduction Act, OMB has taken action on your request received
05/13/2025
ACTION REQUESTED: Generic IC
Fiscal Responsibility Act TANF Pilot Program 2025 Information Collection
IC TITLE:
ICR REFERENCE NUMBER:

202412-0970-005

AGENCY ICR TRACKING NUMBER:
TITLE:

OPRE

Formative Data Collections for ACF Program Support

LIST OF INFORMATION COLLECTIONS: See next page
OMB ACTION: Approved with change
OMB CONTROL NUMBER:

0970-0531

The agency is required to display the OMB Control Number and inform respondents of its legal significance in
accordance with 5 CFR 1320.5(b).
EXPIRATION DATE: 09/30/2025

BURDEN:

DISCONTINUE DATE:

RESPONSES

HOURS

COSTS

Previous

44,913

54,152

1,082,970

New

44,913

54,152

1,082,970

Change due to New Statute

0

0

0

Change due to Agency Discretion

0

0

0

Change due to Agency Adjustment

0

0

0

Change due to PRA Violation

0

0

0

Difference

TERMS OF CLEARANCE:

Terms of the Generic ICR remain in effect.

OMB Authorizing Official:

Dominic J. Mancini
Deputy Administrator,
Office Of Information And Regulatory Affairs

IC Title
Healthy Marriage and
Responsible
Fatherhood Grantee
Data Collection Plan
Template (BUILD)
Strengthening the
Implementation of
Responsible
Fatherhood Programs
(SIRF)
Youth Empowerment
Information, Data
Collection, and
Exploration on
Avoidance of Sex
(IDEAS) – Case Study
of Parent Reflections
Collection of Information
for Local Evaluations as
part of the Personal
Responsibility
Education Program
(PREP): Promising
Youth Programs (PYP)
(PREP PYP Part 2 –
Local Eval templates)
Tribal Maternal, Infant,
and Early Childhood
Home Visiting
(TMIECHV) Grantee
Technical Assistance
(TA) Needs
Assessment
Human Trafficking
Youth Prevention
Education (HTYPE)
Demonstration Grant
Program
Implementation Surveys
Standard Evaluation
Survey for the National
Center for Early
Childhood
Development,
Teaching, and
Learning's
(NCECDTL's) Training
and Technical
Assistance Offerings
ACF Privacy and
Confidentiality Toolkit
Case Studies
Next Generation of
Enhanced Employment
Strategies Project MOMS Partnership
Justification for the
Collection of Information
for Local Evaluations as
part of the Personal
Responsibility
Education Program
(PREP): Promising
Youth Programs (PYP) (PREIS and TPREP
templates)

Form No.

List of ICs
Form Name

CFR Citation

Hrs/$/Resp
678 / 0 / 113

3,157 / 0 / 851

147 / 0 / 240

750 / 0 / 30

38 / 0 / 38

2,658 / 0 / 11,539

195 / 0 / 1,500

41 / 0 / 33
255 / 0 / 1,404

420 / 0 / 84

IC Title
Rapid-Cycle Learning
Plan Template for
Community Services
Block Grant (CSBG)
Project Impact Grant
Recipients
Sexual Risk Avoidance
Education National
Evaluation Program
Components Impact
Study: Proof of Concept
Pilot Phase
Usability Testing of
Resources to Support
the Identification and
Care of Children with
Prenatal Substance or
Alcohol Exposure in the
Child Welfare System
OFA Training and
Technical Assistance
(TTA)
Personal Responsibility
Education Program
(PREP) Local
Evaluation Support
Information to Inform
the Office of Child Care
about Implementation of
Child Care American
Rescue Plan Act
(ARPA) Funds - Feb
2023 Update
Information to Inform
the Office of Child Care
about Implementation of
Child Care American
Rescue Plan Act
(ARPA) Funds for Tribal
Lead Agencies –
Exploration Stage
Information to Inform
the Office of Child Care
about Implementation of
Child Care American
Rescue Plan Act
(ARPA) Funds for Tribal
Lead Agencies in the
Developing Stage
Information to Inform
the Office of Child Care
about Implementation of
Child Care American
Rescue Plan Act
(ARPA) Funds for Tribal
Lead Agencies in the
Initial and Full
Implementation Stages
Strengthening the
Implementation of
Marriage and
Relationship Programs
(SIMR)

Form No.

List of ICs
Form Name

CFR Citation

Hrs/$/Resp
64 / 0 / 48

336 / 0 / 792

375 / 0 / 21

111 / 0 / 666
80 / 0 / 24

153 / 0 / 312

265 / 0 / 265

265 / 0 / 265

265 / 0 / 265

1,895 / 0 / 1,320

IC Title
Administration for
Children and Families
External Speaker
Request Form
Data Collection to
Inform a Curriculum
Adaptation for the
Personal Responsibility
Education Program
(PREP): Promising
Youth Programs (PYP)
Project
Operation Allies
Welcome (OAW)
Resettlement State
Refugee Coordinator
(SRC) Monthly Report
Tribal Early Learning
Initiative (TELI)
Statement of Interest
Pandemic Emergency
Assistance Fund
(PEAF) Recipients
Feedback Survey
Family Economic
Mobility (FEM) Training
and Technical
Assistance Feedback
Multi-Site Study of
State-Tribal
Collaboration in Home
Visiting
Tribal Home Visiting
Continuous Quality
Improvement
Collaboratives
HMRF Grantee Site
Visits and Community
Group Listening
Sessions to Support
Race Equity for
Fatherhood,
Relationship, and
Marriage Programs to
Empower Black
Families (REFRAME)
Services for Survivors
of Torture Medical Care
Survey
TANF and Child
Support Moving
Forward: Lessons
Learned from the
COVID-19 Pandemic
Court Improvement
Program Court System
Structures
Humanitarian Response
Operating Plan
Listening Sessions
Title IV-E Tribal-State
Agreement Evaluation
Diaper Distribution
Demonstration and
Research Pilot Baseline
Data Collection

Form No.

List of ICs
Form Name

CFR Citation

Hrs/$/Resp
30 / 0 / 60

120 / 0 / 204

600 / 0 / 300

90 / 0 / 45
101 / 0 / 135

59 / 0 / 500

63 / 0 / 42

138 / 0 / 138

277 / 0 / 168

23 / 0 / 35
86 / 0 / 93

1,777 / 0 / 7,053
485 / 0 / 485
7 / 0 / 40
683 / 0 / 10,500

IC Title

Form No.

List of ICs
Form Name

CFR Citation

Hrs/$/Resp

Low Income Household
Water Assistance
Program (LIHWAP)
Water Landscape and
Equity Research
Diaper Distribution
Demonstration and
Research Pilot
(DDDRP) Administrative
Data Infrastructure
Survey
ACF Behavioral Health
Survey
Feedback from CLASS
Video Pilot
TANF and Child
Support Moving
Forward: Further
Incorporating Family
Input
Community Injects
Related to Local
Environmental Justice
and Climate Change
Impacts
United for Ukraine

290 / 0 / 580

Feedback from Federal,
State, Tribal, Local, and
Territorial Human
Services Offices on
Emergency
Preparedness and
Response
ORR - Resource
Guides for Discretionary
Grant Programs
Division of Refugee
Services (DRS)
Runaway and
Homeless Youth
Training and Technical
Assistance Center
(RHYTTAC) National
Needs Assessment
ACF Data Request

1,655 / 0 / 1,103

Child Care and
Development Fund
(CCDF) 101: CCDF
Fundamentals Pre/Post
Self-Assessment
The Adulthood
Preparation Subjects
(APSs) Study of
Dosage and Cultural
Relevance
The National Technical
Assistance Center for
Preschool Development
Grants B-5 Parent and
Early Childhood
Professional Partner
Groups

33 / 0 / 100

18 / 0 / 35

73 / 0 / 500
122 / 0 / 1,262
230 / 0 / 176

1,076 / 0 / 881

136 / 0 / 800

114 / 0 / 171

110 / 0 / 440

300 / 0 / 100

135 / 0 / 104

156 / 0 / 150

IC Title

Form No.

List of ICs
Form Name

CFR Citation

Hrs/$/Resp

Immigration Legal
Service for Afghan
Arrivals – Training
Experience Survey and
Topic-Based
Knowledge Assessment
Formative Data
Collections for
American Rescue Plan
(ARP) Act
Supplemental Funding
Program Support
Formative Data
Collections for
American Rescue Plan
(ARP) Act Culturally
Specific Domestic
Violence and Sexual
Assault Supplemental
Funding Survey
Needs Assessment
Survey for the National
Center for Early
Childhood
Development,
Teaching, and
Learning's
(NCECDTL's) Training
and Technical
Assistance Offerings
Office of Refugee
Resettlement (ORR)
Unaccompanied
Children (UC) Program
Youth Engagement
Focus Groups
Immigration Legal
Services for Afghan
Arrivals – Legal Service
Provider Interest Form
TANF Pilot Convenings

77 / 0 / 120

Runaway and
Homeless Youth
Prevention
Demonstration Program
Prevention Plan
Template
Feedback on Materials
for Father Involvement
National Media
Campaign
Strengthening the
Implementation of
Marriage and
Relationship Programs
(SIMR) - Analysis Plan
Template
Immigration Legal
Services for Afghan
Arrivals – Technical
Assistance Interest
Form

88 / 0 / 11

292 / 0 / 292

145 / 0 / 145

114 / 0 / 345

100 / 0 / 50

4 / 0 / 50

300 / 0 / 200

143 / 0 / 594

360 / 0 / 60

16 / 0 / 120

IC Title
Diaper Distribution
Demonstration and
Research Pilot
(DDDRP) Assessment
Child Welfare
Information Gateway
Gov Delivery
Subscription Profile
Form
Center for States
GovDelivery
Subscription Form
Information to Inform
the Office of Child Care
about Implementation of
Child Care American
Rescue Plan Act
(ARPA) Supplemental
Funds – Check-In Call
Interview Questions
ACF Evidence Capacity
Support
Public Access to Diaper
Information
Office of Head Start
Program Information
Report Data Quality
Focus Groups
National Center on
Afterschool and
Summer Enrichment
(NCASE) Out-of-School
Time Workforce Focus
Groups
National Youth in
Transition Database
(NYTD) State Partners
and Supplemental Data
Survey
Tribal Home Visiting
Program Information
Collection for Revision
to Community Needs
Readiness Assessment
(CNRA)
Lookback Survey of
Wilson Fish TANF
Coordination Program
Grant Recipients Over
the Initial Project Period
Unaccompanied
Children Program Care
Providers Education
Services Survey
Child Care and
Development Fund
(CCDF) Information
Technology
Environment Scan

Form No.

List of ICs
Form Name

CFR Citation

Hrs/$/Resp
695 / 0 / 3,852

50 / 0 / 1,000

100 / 0 / 2,000
104 / 0 / 624

80 / 0 / 121
11 / 0 / 22
72 / 0 / 48

108 / 0 / 108

17 / 0 / 52

23 / 0 / 15

7 / 0 / 21

85 / 0 / 169

60 / 0 / 160

IC Title
Feedback After the
Office of Planning,
Research, and
Evaluation's 2024
Research and
Evaluation Conference
on Self-Sufficiency
(RECS)
Supporting Family
Economic Well-Being
through Home Visiting
(HomeEc) Formative
Evaluation
Child Care and
Development Fund
(CCDF) Information
Technology Matters 1
Fiscal Responsibility Act
TANF Pilot Program
Information Collection
Advancing Best
Practices and Cultural
Relevance of Healthy
Marriage and
Responsible
Fatherhood Programs
for Indigenous
Communities (I-HMRF)
Office of Child Care
Technical Assistance
Interest Form:
Improving Child Care
and Part C Integration
or Disability Inclusion in
Child Care
Office of Family
Violence Prevention
and Services Outcome
Measurement Listening
Session
Unaccompanied
Children Office of the
Ombuds Report of a
Concern
Refugee Support
Services Refugee
Health Promotion SetAside Programs
Assessment Guide
Refugee Support
Services Youth
Mentoring Set-Aside
Programs Assessment
Guides
Office of Refugee
Resettlement
Unaccompanied
Children Bureau
Normalcy Integration
Survey
Child Care and
Development Fund
(CCDF) Information
Technology Matters 2

Form No.

List of ICs
Form Name

CFR Citation

Hrs/$/Resp
60 / 0 / 174

222 / 0 / 876

51 / 0 / 51

400 / 0 / 40
133 / 0 / 100

28 / 0 / 56

45 / 0 / 30

300 / 0 / 600

85 / 0 / 85

132 / 0 / 215

1,800 / 0 / 3,600

51 / 0 / 51

IC Title
Survey for Staff
Supporting Infants and
Toddlers for the
National Center for
Early Childhood
Development,
Teaching, and
Learning's
(NCECDTL's) Training
and Technical
Assistance Offerings
SAVES Center Data
Collection for Program
Improvement
Child Care and
Development Fund
(CCDF) Application for
Intensive Consultation Information Technology
Strategic Roadmap
Development
Supporting Coordinated
Benefits Delivery to
Foster Whole Family
Approaches
Feedback on the
HomVEE Criteria for
Evidence-Based Early
Childhood Home
Visiting Models
Identification of Current
Infant and Early
Childhood Mental
Health Consultation
(IECMHC) Services and
Points of Contact
Across the U.S. and
U.S. Territories.
Personal Responsibility
Education Program
(PREP) Local
Evaluation Support
Instruments
Child Care and
Development Fund
(CCDF) Tribal Listening
Sessions on Use of
Information Technology
Survey on Tribal
Homelessness and
Housing Support for
Communities that Utilize
Tribal TANF
Pathways to Work
Evidence
Clearinghouse
Feedback Sessions
Child Care and
Development Fund
(CCDF) Information
Technology Matters 3
TANF Data
Collaborative (TDC) 2.0
– Formative Data
Collection

Form No.

List of ICs
Form Name

CFR Citation

Hrs/$/Resp
198 / 0 / 600

4 / 0 / 1,464
17 / 0 / 87

296 / 0 / 576

73 / 0 / 73

159 / 0 / 271

184 / 0 / 262

150 / 0 / 150

33 / 0 / 100

96 / 0 / 48

51 / 0 / 51

40 / 0 / 60

IC Title

Form No.

List of ICs
Form Name

CFR Citation

"Research Ready
Grantee" Intake Form
Office of Family
Violence Prevention
and Services Formula
Grantees Performance
Progress Report (PPR)
Listening Sessions
Oklahoma Domestic
Violence State Coalition
Community Participant
Listening Sessions
U.S. Virgin Islands
Domestic Violence
Territory Coalition
Community Participant
Listening Sessions
Office of Refugee
Resettlement (ORR)
Unaccompanied
Children Bureau Policy
Evaluation Focus
Groups
Survey on Healthy
Marriage and
Responsible
Fatherhood Practices
for Collecting and
Monitoring Outreach
and Recruitment Data
Strategies To Respond
to Intimate Violence
Effectively (STRIVE)
Fiscal Responsibility Act
TANF Pilot Program
2025 Information
Collection
Survey on Low Income
Home Energy
Assistance Program
(LIHEAP) Information
Technology (IT)
Solutions
Tribal Early Learning
Initative Statement of
Interest – FY26 Cohort
Runaway and
Homeless Youth
Training, Technical
Assistance, and
Capacity Building
Center (RHYTTAC)
National Needs
Assessment - 2025
Tribal TANF Institutional
Review Board (IRB)
Outreach
Total Hours Actually Used for Information Collections Under Currently Approved ICR:

Hrs/$/Resp
27 / 0 / 320
460 / 0 / 460

475 / 0 / 300

675 / 0 / 400

300 / 0 / 240

125 / 0 / 500

175 / 0 / 392
250 / 0 / 25

102 / 0 / 51

90 / 0 / 45
118 / 0 / 235

89 / 0 / 76
31,680