| Domestic Victims of Human Trafficking Program Data |
Grantee: (Name of Organization) |
| THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: Through this information collection, ACF is gathering data on the grant program to assess program performance, inform evaluation, tailor technical assistance, report to stakeholders, and inform policy and program development. Public reporting burden for this collection of information is estimated to average .75 hour per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This collection of information is required to retain a benefit (22 USC 7105, Trafficking Victims Protection Act). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number.If you have any comments on this collection of information, please contact Flavia Keenan-Guerra, Office on Trafficking in Persons, by email at Flavia.Keenan-Guerra@acf.hhs.gov. |
| Case Management-Categories of Assistance |
OTIP:
Record the number of clients who received each type of service during the reporting period.
Number of Clients |
OTIP:
Record the amount of grant funds spent on all costs associated with providing direct services to clients (e.g, subrecipient reimbursement, subcontracted services, or payments to provided to referral partners for client services)
Total Funds Spent |
% of Project Budget |
| Advocacy |
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#DIV/0! |
| Case Management |
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#DIV/0! |
| Child Care |
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#DIV/0! |
| Clothing (Basic Necessities) |
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#DIV/0! |
| Crisis Intervention |
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#DIV/0! |
| Dental Health |
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#DIV/0! |
| Education |
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#DIV/0! |
| Employment and Job Skills |
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#DIV/0! |
| Family Reunification |
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#DIV/0! |
| Food (Basic Necessities) |
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#DIV/0! |
| Financial Assistance |
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#DIV/0! |
| Housing/Shelter |
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#DIV/0! |
| Interpreter/Translator |
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#DIV/0! |
| Legal |
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#DIV/0! |
| Life Skills |
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#DIV/0! |
| Medical Care/Physical Health |
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#DIV/0! |
| Mental/Behavioral Health |
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#DIV/0! |
| Personal Care Items (Basic Necessities) |
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#DIV/0! |
| Safety Planning |
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#DIV/0! |
| Substance Use Assessment/Treatment |
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#DIV/0! |
| Traditional Healing/Cultural Practices |
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#DIV/0! |
| Transportation |
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#DIV/0! |
| Vision Care |
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#DIV/0! |
| Other |
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#DIV/0! |
| Total Direct Services Spending |
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$- |
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Khaila Montgomery:
Program administration spending includes funds allocated to administering the grant (e.g., cost of site visits, travel, salaries for administrative staff, etc.). This category excludes funds spent on case management or direct services. Funds spent on the salary/benefits for case managers delivering services under the grant should be recorded under case management in direct services.
Total Program Administration Spending |
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Khaila Montgomery:
This is the amount of funding OTIP provided that grantee is authorized to spend during fiscal year
Total Grantee Budget for Project |
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