View Information Collection (IC)

View Information Collection (IC)

IC Title:	Formative Data Collections for American Rescue Plan (ARP) Act Culturally Specific Domestic Violence and Sexual Assault Supplemental Funding Survey	Agency IC Tracking Number:	OFVPS

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-survey			FVPSA ARP Act CSSIRCs ANTRC and NIRC Survey Questions_FINAL CLEAN.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 145	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	145	0	145	0	0	0
Annual IC Time Burden (Hours)	145	0	145	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
SSA - Formative Data Collections for ARP Act Culturally Specific Domestic Violence and Sexual Assault Supplemental Funding Survey	FVPSA Formative for ACF Program Support - ARP Culturally Specific DV_SA Supp Survey.docx	07/14/2023

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.