Family Violence Prevention and Services: Grants to States; Native American Tribes and Alaskan Native Villages; and State Domestic Violence Coalitions

Forms and Documents

Document Name	Status
Form 1 FVPSA Coalition PPR Form and Instruction	Modified
Form 1 FVPSA STATE PERFORMANCE REPORT Form and Instruction	Modified
Supporting Statement for OMB Clearance 2014 updated format.doc Supporting Statement A	2014-07-01

IC Document Collections

IC ID	Document Title	Status
212203	FVPSA Coalition PPR Form and Instruction	Modified
186809	FVPSA TRIBAL PERFORMANCE REPORT	Modified
186808	FVPSA STATE PERFORMANCE REPORT Form and Instruction	Modified
186807	FVPSA STATE COALITION PROGRAM ANNOUNCEMENT Instruction	Modified
186806	FVPSA TRIBAL PROGRAM ANNOUNCEMENT Instruction	Modified
10138	FVPSA STATE GRANT PROGRAM ANNOUNCEMENT Instruction	Modified

ICR Details

OMB Control No: 0970-0280	ICR Reference No: 201411-0970-001
Status: Historical Inactive	Previous ICR Reference No: 201406-0970-010
Agency/Subagency: HHS/ACF	Agency Tracking No: ACYF
Title: Family Violence Prevention and Services: Grants to States; Native American Tribes and Alaskan Native Villages; and State Domestic Violence Coalitions
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn and continue	Conclusion Date: 12/10/2014
	Date Received in OIRA: 11/14/2014
Terms of Clearance: Withdraw at agency request

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2017	36 Months From Approved	09/30/2017
Responses	518	0	518
Time Burden (Hours)	4,430	0	4,430
Cost Burden (Dollars)	0	0	0

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Abstract: The information that we receive and compile from the annual program reports is used in the development of planning guidance provided to the field, for staff training, program improvement actions, and used in the development of our discretionary programs.

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Authorizing Statute(s): US Code: 42 USC 10401 Name of Law: Family Violence Prevention
  

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:
	79 FR 18917	04/04/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 37322	11/04/2014
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 6

IC Title	Form No.	Form Name
FVPSA Coalition PPR	1	Coalition PPR
FVPSA STATE GRANT PROGRAM ANNOUNCEMENT
FVPSA TRIBAL PROGRAM ANNOUNCEMENT
FVPSA STATE COALITION PROGRAM ANNOUNCEMENT
FVPSA STATE PERFORMANCE REPORT	1	Staate PPR
FVPSA TRIBAL PERFORMANCE REPORT

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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: $0

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]? 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? 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: 11/14/2014

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