Certification with the Statutory Eligibility Requirements of the Violence Against Women Act as Amended and the Prison Rape Elimination Act for the STOPFormula Grant Program

Documents and Forms

Document Name Document Type
Form 1122-0029 Certification with the Statutory Eligibility Requirements of the Violence Against Women Act as Amended and the Prison Rape Elimination Act for the STOPFormula Grant Program Form
1122-0029 PREA Worksheet PREAFORM.pdf www.justice.gov/ovw/file/789921/download Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Certification with the Statutory Eligibility Requirements of the Violence Against Women Act as Amended and the Prison Rape Elimination Act for the STOPFormula Grant Program	Agency IC Tracking Number:	1122-0029

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1122-0029	PREA Worksheet	PREAFORM.pdf	https://www.justice.gov/ovw/file/789921/download	Yes	Yes	Fillable Fileable Signable

Line of Business: Law Enforcement

Subfunction: Crime Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 56	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	56	56
Annual IC Time Burden (Hours)	48	48
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.