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Subrecipient Data Collection and Reporting Form (Instrument 4)
Personal Responsibility Education Program (PREP) Performance Measures
OMB: 0970-0497
IC ID: 223555
OMB.report
HHS/ACF
OMB 0970-0497
ICR 202306-0970-003
IC 223555
( )
Documents and Forms
Document Name
Document Type
Instrument 4a_PREP Subawardee Data Collection & Reporting Form (2022-2023).docx
Other-Data Entry Form (2022-2023)
Instrument 4a_PREP Subawardee Data Collection & Reporting Form (2022-2023).docx
Other-Data Entry Form (2022-2023)
Instrument 4b_PREP Subawardee Data Collection Reporting Form (2023+).docx
Other-Data Entry Form (2023 +)
Instrument 4b_PREP Subawardee Data Collection Reporting Form (2023+).docx
Other-Data Entry Form (2023 +)
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Subrecipient Data Collection and Reporting Form (Instrument 4)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
Other-Data Entry Form (2022-2023)
Instrument 4a_PREP Subawardee Data Collection & Reporting Form (2022-2023).docx
Yes
Yes
Fillable Fileable
Other-Data Entry Form (2023 +)
Instrument 4b_PREP Subawardee Data Collection Reporting Form (2023+).docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
360
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
720
0
0
-80
0
800
Annual IC Time Burden (Hours)
9,784
0
0
-1,120
0
10,904
Annual IC Cost Burden (Dollars)
0
0
0
0
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.