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View ICR - OIRA Conclusion

OMB Control No: 0970-0382	ICR Reference No: 202005-0970-003
Status: Historical Active	Previous ICR Reference No: 201803-0970-002
Agency/Subagency: HHS/ACF	Agency Tracking No: OCS
Title: Community Services Block Grant (CSBG) Program Model Plan Applications
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: 05/05/2020
	Date Received in OIRA: 05/05/2020
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2021	06/30/2021	06/30/2021
Responses	1,187	0	1,131
Time Burden (Hours)	3,159	0	1,983
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	1,187	1,131	56
Annual Time Burden (Hours)	3,159	1,983	1,176
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The CSBG CARES Supplemental State Plan is a supplement of the CSBG State Plan. The CSBG CARES Supplemental State Plan is a revision of the original questions in the CSBG State Plan to specifically ask the states’ (CSBG grantees) about their work as it directly relates to CSBG CARES funding.

Annual Cost to Federal Government: $13,440

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. 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: Molly Buck 202 205-4724 mary.buck@acf.hhs.gov

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