Compassion Capital Fund Program Evaluation-Baseline and Follow-Up

Forms and Documents

Document Name	Status
Form 0 Compassion Capital Fund Program Evaluation-Baseline and Follow-Up Form and Instruction	Modified
Justification Attachment for 0970-0293.doc Justification for No Material/Nonsubstantive Change	2006-10-12

IC Document Collections

IC ID	Document Title	Status
10151	Compassion Capital Fund Program Evaluation-Baseline and Follow-Up Form and Instruction	Modified

ICR Details

OMB Control No: 0970-0293	ICR Reference No: 200610-0970-006
Status: Historical Active	Previous ICR Reference No: 200509-0970-002
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: Compassion Capital Fund Program Evaluation-Baseline and Follow-Up
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 with change	Conclusion Date: 12/18/2006
	Date Received in OIRA: 10/20/2006
Terms of Clearance: This ICR is approved on the condition that 1) ACF and/or the contractor conducts routine quality checks to make sure that respondents who filled out the “old” baseline form and then fill out the “new” follow-up form are submitting responses that make sense, and 2)that ACF and/or the contractor follows-up with respondents to make sure that their original responses on the “old” baseline form were accurate so as to ensure comparability of results.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2008	12/31/2008	12/31/2008
Responses	1,575	0	1,575
Time Burden (Hours)	583	0	583
Cost Burden (Dollars)	0	0	0

---

Abstract: The Compassion Capital Fund Evaluation will evaluate the outcomes and effectiveness of organizational capacity building services provided by Intermediary organizations to faith-based and community organizations (fbco). The baseline survey will provide a description of the state of organizational capacity of the fbcos and the follow-up survey, to be administered approximately 15 months later, will provide a description of changes and improvements in organizational capacity among the organizations in the study.

---

Authorizing Statute(s): None

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Compassion Capital Fund Program Evaluation-Baseline and Follow-Up	0, 0, 0, 0, 0, 0	a ,   a ,   a ,   a ,   a ,   a

---

ICR Summary 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	1,575	1,575	0	0	0	0
Annual Time Burden (Hours)	583	583	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:

---

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

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: 10/17/2006

---