Mentoring Children of Prisoners Relationship Quality Survey

Forms and Documents

Document Name	Status
Form 1 Mentoring Children of Prisoners Relationship Quality Survey Form and Instruction	Modified
Supporting_Statement for 0308 RQI 2009 with Part B.docx Supporting Statement B	2009-10-13
Supporting Statement.doc Supporting Statement A	2009-05-18

IC Document Collections

IC ID	Document Title	Status
43729	Mentoring Children of Prisoners Relationship Quality Survey Form and Instruction	Modified

ICR Details

OMB Control No: 0970-0308	ICR Reference No: 200905-0970-003
Status: Historical Active	Previous ICR Reference No: 200606-0970-004
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: Mentoring Children of Prisoners Relationship Quality Survey
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 10/13/2009
	Date Received in OIRA: 05/18/2009
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2012	36 Months From Approved	10/31/2009
Responses	24,940	0	215
Time Burden (Hours)	24,940	0	24,940
Cost Burden (Dollars)	0	0	624,000

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Abstract: Public Law 107-133 provides for funding to public or non profit agencies that recruit, screen, train, and support mentors for children with an incarcerated parent or parents. Pursuant to annual performance planning and reporting requirements placed upon Federal agencies by the Government Performance and Results Act, and in order to maintain oversight and exercise proper stewardship of taxpayer-funded programs, FYSB, the administering federal agency, must regularly collect information on outputs and outcomes of the mentoring program.

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Authorizing Statute(s): PL: Pub.L. 107 - 133 IV-B Name of Law: Social Security Act
  

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:
	74 FR 814	01/08/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 20706	05/05/2009
Did the Agency receive public comments on this ICR? Yes

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

IC Title	Form No.	Form Name
Mentoring Children of Prisoners Relationship Quality Survey	1	Survey Form

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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	24,940	215	0	0	24,725	0
Annual Time Burden (Hours)	24,940	24,940	0	0	0	0
Annual Cost Burden (Dollars)	0	624,000	0	0	-624,000	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:

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Annual Cost to Federal Government: $72,700

Does this IC contain surveys, censuses, or employ statistical methods? No

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)? No

Is this ICR related to the Pandemic Response? Uncollected

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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: 05/18/2009

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