PMOTOOL

Forms and Documents

Document Name	Status
Form 1 Child Welfare Training Form and Instruction	New
Form 1 Child Abuse and Neglect Form and Instruction	New
Form 1 AO1 Form and Instruction	New
Form 1 Infant Adoption Awareness Program Form and Instruction	New
Form 1 Abandoned Infants Assistance Form and Instruction	New
SUPPORTING STATEMENT - pmotool 2012.docx Supporting Statement A	2012-07-17

IC Document Collections

IC ID	Document Title	Status
203291	Child Welfare Training Form and Instruction	New
203290	Child Abuse and Neglect Form and Instruction	New
203289	AO1 Form and Instruction	New
203288	Infant Adoption Awareness Program Form and Instruction	New
203287	Abandoned Infants Assistance Form and Instruction	New

ICR Details

OMB Control No: 0970-0412	ICR Reference No: 201207-0970-003
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: PMOTOOL
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/02/2012
	Date Received in OIRA: 07/17/2012
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2015	36 Months From Approved
Responses	282	0	0
Time Burden (Hours)	282	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of this data collection is to assist the Children's Bureau in using the aggregated data to examine the social impact or public benefit under each federal program. These measurable outcomes will serve as evidence that the federally funded programs are making progress toward achieving broad, legislative program goals.

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Authorizing Statute(s): US Code: 31 USC 105 Name of Law: GPRA
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 10751	02/23/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 39496	07/03/2012
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

IC Title	Form No.	Form Name
Abandoned Infants Assistance	1	Abandon Infants
Infant Adoption Awareness Program	1	IAATP
AO1	1	AO1
Child Abuse and Neglect	1	Child Abuse and Neglect
Child Welfare Training	1	CWT

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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	282	0	0	282	0	0
Annual Time Burden (Hours)	282	0	0	282	0	0
Annual Cost Burden (Dollars)	0	0	0	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: New collection.

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Annual Cost to Federal Government: $29,830

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

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Common Form ICR:  No

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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: 07/17/2012

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