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OMB Control No:	ICR Reference No: 202512-1122-001
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: DOJ/OVW	Agency Tracking No:
Title: Optional Flexible Financial Assistance for Victims Program (FAV Program) Survey
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 12/16/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	2,600	0
Time Burden (Hours)	433	0
Cost Burden (Dollars)	24,556	0

ICR Summary of Burden

	Total Request	Change Due to Agency Discretion
Annual Number of Responses	2,600	2,600
Annual Time Burden (Hours)	433	433
Annual Cost Burden (Dollars)	24,556	24,556

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: There is no burden increase. This is a new information collection.

Annual Cost to Federal Government: $24,556

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? No

Agency Contact: Tiffany Watson 202 717-5871 tiffany.watson@usdoj.gov

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