Domestic Violence and Housing Technical Assistance Consortium Safe Housing Needs Assessment

Documents and Forms

Document Name Document Type
Form 1122-XXX Domestic Violence and Housing Technical Assistance Consortium Safe Housing Needs Assessment Form
1122-XXX Safe Housing Needs Assessment Homeless Shelter and Housing Providers_Feedback Incorporated_NASH.pdf www.usdoj.gov/ovw Form
1122-XXXX Safe Housing Needs Assessment Domestic and Sexual Violence Organizations_ Needs Assessment Questions_Final with RevisionIncorporation_NASH (003).pdf www.usdoj.gov/ovw Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Domestic Violence and Housing Technical Assistance Consortium Safe Housing Needs Assessment	Agency IC Tracking Number:	1122-XXXX

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1122-XXX	Safe Housing Needs Assessment	Homeless Shelter and Housing Providers_Feedback Incorporated_NASH.pdf	www.usdoj.gov/ovw	Yes	Yes	Fillable Fileable Signable
Form	1122-XXXX	Safe Housing Needs Assessment	Domestic and Sexual Violence Organizations_ Needs Assessment Questions_Final with RevisionIncorporation_NASH (003).pdf	www.usdoj.gov/ovw	Yes	Yes	Fillable Fileable Signable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 78,660	Number of Respondents for Small Entity: 78,660

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	78,660	78,660
Annual IC Time Burden (Hours)	19,665	19,665
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.