View Information Collection Request (ICR) Package

OMB Control No: 0970-0362	ICR Reference No: 201108-0970-008
Status: Historical Active	Previous ICR Reference No: 200908-0970-002
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: Request for Assistance for Child Victims of Human Trafficking
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/12/2011
	Date Received in OIRA: 08/25/2011
Terms of Clearance: The information collection is approved for three years. However, the agency is reminded that it must provide separate estimates of burden changes due to adjustments and those due program revisions.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2014	36 Months From Approved	10/31/2012
Responses	200	0	50
Time Burden (Hours)	200	0	75
Cost Burden (Dollars)	0	0	0

Abstract: The TVPRA 2008 directs HHS upon receipt of credible information that a non-U.S. citizen, non-lawful permanent resident (alien) child may have been subjected to a severe form of trafficking in persons and is seeking Federal assistance available to victims of trafficking, to promptly determine if the child is eligble for interim assistance. The law further directs HSS to determine if the child is eligble for assistance as a victim of a severe form of trafficking in persons after consultation with the Attorney General, the Secretary of Homeland Security, and nongovernmental organizations with expertise on victims of severe form of trafficking. In developing procedures for collecting the neccessary informaiton from potential child victims of trafficking, their case managers, attorneys, or other representatives to allow HHS to grant interim eligbility, HHS devised a form. HHS has determined that the use of a standard form to collect iformation is the best way to ensure requestors are notified of their option to request assistance for child victims of trafficking and to make prompt and consistent determinations about the child's eligbility for interim assistance. Specifcially, the form asks the requestor for his/her identifying information, for information on the child, information describing the type of trafficking and circumstances surrounding the situation, and the strengths and needs of the child. The form also asks the requestor to verify the information contained in the form becuase the information could be the basis for a determination of an alien child's eligibiltiy for federally funded benefits. Finally, the form takes into consideration the need to compile information regarding a child's circumstances and experiences in a non-directive, child-friendly way, and assists the potential requestor in assessing whether the child may have been subjected to trafficking in persons.

Authorizing Statute(s): PL: Pub.L. 110 - 457 212 Name of Law: TVPRA

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
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 27060	05/10/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 47196	08/04/2011
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
Request for Assistance for Child Victims of Human Trafficking	1

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	200	50	150
Annual Time Burden (Hours)	200	75	125
Annual Cost Burden (Dollars)	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: $56,000

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

Agency Contact: Robert Sargis 2026907275

View ICR - OIRA Conclusion