Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
This script is used to control the display of information in this page.
Display additional information by clicking on the following:
All
Brief and OIRA conclusion
Abstract/Justification
Legal Statutes
Rulemaking
FR Notices/Comments
IC List
Burden
Misc.
Common Form Info.
Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0970-0403
ICR Reference No:
201307-0970-009
Status:
Historical Active
Previous ICR Reference No:
201303-0970-001
Agency/Subagency:
HHS/ACF
Agency Tracking No:
20120
Title:
Parents and Children Together (PACT) Evaluation
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 without change
Conclusion Date:
08/27/2013
Retrieve Notice of Action (NOA)
Date Received in OIRA:
07/23/2013
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
07/31/2016
07/31/2016
07/31/2016
Responses
198,667
0
198,667
Time Burden (Hours)
13,116
0
13,116
Cost Burden (Dollars)
0
0
0
Abstract:
This information collection request (ICR) is for clearance to collect information for the Parents and Children Together (PACT) evaluation of a subset of Responsible Fatherhood (RF) and Healthy Marriage (HM) grants authorized under the Claims Resolution Act of 2010 (public law 111-291). Work under PACT will be carried out in stages with different types of information collection in each stage. Thus, requests for clearance will be submitted in stages as work progresses. This ICR includes: continued use of four existing approved instruments (currently approved under this control number - 0970-0403); clearance for eleven new data collection instruments, for use in the impact evaluations (which includes implementation/qualitative strategies); and clearance for three new instruments for use in implementation/qualitative only evaluation.
Authorizing Statute(s):
PL:
Pub.L. 111 - 291 403
Name of Law: Claims Resolution Act of 2010
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?
Yes
Number of Information Collection (IC) in this ICR:
21
IC Title
Form No.
Form Name
Instrument #10: Telephone interviews (with staff at referral organizations)
Instrument #12: Focus Group Guide
Instrument #13: Telephone interviews - Program participants (program dropouts)
Instrument #14: Guide for in-person, in-depth interviews with study participants
Instrument #15: Check in Call Guide
Instrument #16: Semi-structured interview topic guide - Hispanic Population Focus
Instrument #17: Focus Group Guide - Hispanic Population Focused
Instrument #18: Questionnaires for Participants in Focus Group with Hispanic Population Focus
Instrument #1: PACT - Discussion Guide
Instrument #2a: Introductory Script - Grantee Staff
Instrument #2b: Introductory Script - Program Applicants
Instrument #3 - Baseline Survey
Instrument #6 - RF Study MIS
Instrument #7: HM Study MIS
Instrument #8: Semi-structured interview topic guide
Instrument #9: On-line Survey for Program Staff
Instrument 11a: On-line Working Alliance Inventory - Program Staff
Instrument 11b: On-line Working Alliance Inventory - Participants
Instrument 4a: Introductory script - Program Staff Burden
Instrument 4b: Introductory script - HM Program Applicants
Instrument 5: Baseline survey - HM Study Participants
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
198,667
198,667
0
0
0
0
Annual Time Burden (Hours)
13,116
13,116
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:
$3,845,157
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]?
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:
Steve Hanmer 202 401-5651 Steven.Hanmer@ACF.hhs.gov
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:
07/23/2013
An official website of the United States government
The .gov means it's official.
The site is secure.
