Fvpsa Tribal Performance Report

Family Violence Prevention and Services: Grants to States; Native American Tribes and Alaskan Native Villages; and State Domestic Violence Coalitions

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0280 can be found here:

Documents and Forms

Document Name Document Type
Form 1 FVPSA TRIBAL PERFORMANCE REPORT Form
1 NewFVPSAStateTribalPPR NewFVPSAStateTribalPPRforOMBreviewver2.docx Form

Information Collection (IC) Details

IC Title:	FVPSA TRIBAL PERFORMANCE REPORT	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 1370

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	NewFVPSAStateTribalPPR	NewFVPSAStateTribalPPRforOMBreviewver2.docx		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 150	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	1,500	1,500
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.