Campus Program Grantee Needs and Progress Assessment Tool

Forms and Documents

Document Name	Status
Form 1122-XXXX Campus Program Grantee Needs and Progress Assesment Tool Form	New
Core Competency Assessment_Template for Part B Supporting Statement Statistical Methods.docx Supporting Statement B	2016-10-04
ombrociscampusassessment2016supportstatment.doc Supporting Statement A	2016-10-04
Campusstatute2016.docx Supplementary Document	2016-05-11

IC Document Collections

IC ID	Document Title	Status
221452	Campus Program Grantee Needs and Progress Assesment Tool Form	New

ICR Details

OMB Control No: 1122-0031	ICR Reference No: 201605-1122-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOJ/OVW	Agency Tracking No: 1122-XXXX
Title: Campus Program Grantee Needs and Progress Assessment Tool
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 with change	Conclusion Date: 10/04/2016
	Date Received in OIRA: 06/22/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2019	36 Months From Approved
Responses	100	0	0
Time Burden (Hours)	200	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: The Grantee Needs and Progress Assessment Tool will be used to determine the training and technical assistance needs of Campus Program grantees – both new and continuation grantees – throughout the life of the grant award as well measure the development of the capacity of grantees to respond and prevent violence against women on their campuses. In addition, the tool will help campuses and OVW document the impact of their grant- funded work, promote sustainability of important intervention and prevention activities, and provide outcome-based information throughout the life of the grant to help OVW –funded technical assistance providers and grantees make changes to the goals and objectives necessary to achieve the statutory intent when Congress authorized the Campus Program.

---

Authorizing Statute(s): US Code: 42 USC 14045b Name of Law: Violence Against Women Act
  

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:
	81 FR 5484	02/02/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 20676	04/08/2016
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
Campus Program Grantee Needs and Progress Assesment Tool	1122-XXXX	Campus Program Grantee Needs and Progress Assesment Tool

---

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	100	0	0	100	0	0
Annual Time Burden (Hours)	200	0	0	200	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: In order to assess the effectiveness of each grant and the grant program overall, OVW seeks information that can assist in delivering enhanced training and technical assistance to Campus Program grantees and inform decisions about future implementation of this important federal grant program.

---

Annual Cost to Federal Government: $11,200

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

---

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: 06/22/2016

---