Forms and Documents

Document Name	Status
Form 4 Tribal Maternal, Infant, and Early Childhood Home Visiting Program Form 4: Quarterly Performance Reporting Form Form and Instruction	Unchanged
Form 1 Administration for Native Americans (ANA) American Rescue Plan Emergency Language (ARP EL) Progress Report and Post Project Report. Form	Unchanged
Form Part A Wilson-Fish TANF Coordination Project Performance Report Part A and B Form	Unchanged
Form 1 ORR Department of Unaccompanied Children Operations (DUCO); Home Study (HS) and Post Release (PRS) Grantee Data Collection Form	Unchanged
Form 1 Wilson-Fish Alternative Program Fiscal Year Recipient Report Form	Unchanged
Form 1 Microenterprise Development Program Indicators Form	Unchanged
Form 1 Ethnic Community Self-Help (ECSH) Program Data Indicators Form	Unchanged
Form 1 Community Collaborations to Strengthen and Preserve Families Semiannual ACF Performance Progress Report; Appendix B - Program Indicators Form and Instruction	Unchanged
Form 1 Preschool Development Grant Birth through Five (PDG B-5) Renewal Grant Annual Performance Progress Report Form and Instruction	Modified
Form 1 Refugee Agricultural Partnership Program (RAPP) Form	Unchanged
Form 1 Head Start Collaboration Office Annual Report Form and Instruction	Unchanged
Form 1 Refugee Resettlement Refugee Career Pathways Program Performance Data Form	Unchanged
Form 1 Refugee Health Promotion Data Indicators Form	Unchanged
Form 1 Refugee Individual Development Accounts (IDA) Program Indicators Form	Unchanged
Form 1 Preferred Communities Program Data Points Form	Unchanged
Form 1 Survivors of Torture Program Data Points Form	Unchanged
Form 1 ORR Refugee Family Child Care Microenterprise Program Performance Data Form	Unchanged
PDG B-5 APPR Non-Substantive Change Request to OMB 08-31-22 REVISED.docx Justification for No Material/Nonsubstantive Change	2022-08-31
NonSub Change Request _ORR_Generic PPRs - ECSH_0970-0490_06.9.22.docx Justification for No Material/Nonsubstantive Change	2022-06-09
PDG B-5 APPR Non-Substantive Change Request to OMB 11-19-21 FINAL.docx Justification for No Material/Nonsubstantive Change	2021-12-08
NonSub Change Request _ORR_Generic PPRs - PC_ECSH_SOT_0970-0490_10.20.21.docx Justification for No Material/Nonsubstantive Change	2021-10-20
NonSub Change Request - HSCO Annual Report_C.docx Justification for No Material/Nonsubstantive Change	2021-09-02
NonSub Change Request WF TCP_0970-0490.docx Justification for No Material/Nonsubstantive Change	2021-08-19
NonSub Change Request Template_GenIC.docx Justification for No Material/Nonsubstantive Change	2020-09-16
NonSub Change Request - ORR SOT GenIC PPR_0970-0490.docx Justification for No Material/Nonsubstantive Change	2020-06-03
MED NonSub Change Request.docx Justification for No Material/Nonsubstantive Change	2020-02-04
SSA - ACF Generic PPR - Renewal 2019 - 1.15.20_clean.docx Supporting Statement A	2020-01-15
NOA - December 2019 - All approved ICRs_0970-0490.pdf Supplementary Document	2019-12-09
Attachment B - ACF OGM PPR_0970-0406.docx Supplementary Document	2019-12-09
Attachment A - Submission Template for PPR Gen IC (0970-0490)_updated Jan 2020.docx Supplementary Document	2020-01-15

IC Document Collections

IC ID	Document Title	Status
250345	Tribal Maternal, Infant, and Early Childhood Home Visiting Program Form 4: Quarterly Performance Reporting Form Form and Instruction	Unchanged
248395	Administration for Native Americans (ANA) American Rescue Plan Emergency Language (ARP EL) Progress Report and Post Project Report. Form	Unchanged
248317	Wilson-Fish TANF Coordination Project Performance Report Part A and B Form	Unchanged
245281	Human Trafficking Youth Prevention Education (HTYPE) Demonstration Grant Program Performance Indicators Other-Performance Indicators	Unchanged
238830	ORR Department of Unaccompanied Children Operations (DUCO); Home Study (HS) and Post Release (PRS) Grantee Data Collection Form	Unchanged
238829	Wilson-Fish Alternative Program Fiscal Year Recipient Report Form	Unchanged
238828	Microenterprise Development Program Indicators Form	Unchanged
238827	Ethnic Community Self-Help (ECSH) Program Data Indicators Form	Unchanged
238826	Community Collaborations to Strengthen and Preserve Families Semiannual ACF Performance Progress Report; Appendix B - Program Indicators Form and Instruction	Unchanged
238825	Preschool Development Grant Birth through Five (PDG B-5) Renewal Grant Annual Performance Progress Report Form and Instruction	Modified
238824	Refugee Agricultural Partnership Program (RAPP) Form	Unchanged
238823	Head Start Collaboration Office Annual Report Form and Instruction	Unchanged
238822	Refugee Resettlement Refugee Career Pathways Program Performance Data Form	Unchanged
238821	Refugee Health Promotion Data Indicators Form	Unchanged
238820	Refugee Individual Development Accounts (IDA) Program Indicators Form	Unchanged
238819	Preferred Communities Program Data Points Form	Unchanged
238818	Survivors of Torture Program Data Points Form	Unchanged
238817	ORR Refugee Family Child Care Microenterprise Program Performance Data Form	Unchanged

ICR Details

OMB Control No:	ICR Reference No:
Status:	Previous ICR Reference No:
Agency/Subagency:	Agency Tracking No:
Title:
Type of Information Collection:	Common Form ICR:
Type of Review Request:	Date Received in OIRA:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract:

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR?

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Number of Information Collection (IC) in this ICR: 0

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ICR Summary of Burden

	Total	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	0	0	0	0	0	0
Annual Time Burden (Hours)	0	0	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion:

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion:

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government:

Does this IC contain surveys, censuses, or employ statistical methods?

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.    

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.    

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?

Is this ICR related to the Pandemic Response?

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Common Form ICR: 

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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:

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