Generic PPR Submission Form - ECSH Program Data Indicators

Request for approval under the clearance of the “Generic Performance Progress Report” OMB control Number: 0970-0490

TITLE OF INFORMATION COLLECTION: Ethnic Community Self-Help (ECSH) Program Data Indicators

PURPOSE: The purpose of the ECSH Data Indicators is to collect information on grantees’ performance of the ECSH Program on a semi-annual basis. The data will be used to help the Office of Refugee Resettlement (ORR) assess the progress of the ECSH Program in terms of the Program’s three main objectives. The objectives of the ECSH Program are: 1) to strengthen ECBOs’ provision of culturally and linguistically appropriate services to refugees within five years after their initial resettlement; 2) to support ECBOs' organizational development and engagement in capacity building by encouraging their collaboration with established refugee service providers and mainstream organizations; and 3) to support ECBOs in promoting community building and civic participation by refugee individuals and refugee community members

DESCRIPTION OF RESPONDENTS: Private sector: Non-profit (Community-Based Organizations)

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary and in compliance with HHS regulations.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

Name: Zahra Cheema, Program Specialist, Office of Refugee Resettlement

To assist OMB review of your request, please provide answers to the following question:

PERSONALLY IDENTIFIABLE INFORMATION:

1. Is personally identifiable information (PII) collected? [ ] Yes [X ] No

2. If Yes, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No

3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [ ] No

BURDEN HOURS

Category of Respondent	No. of Respondents	No. of Responses per Respondent	Burden per Response	Total Burden
Non-Profit Organizations	48	2	2 hours	192 hours

FEDERAL COST: The estimated annual cost to the Federal government is $2,000.

TYPE OF COLLECTION:

How will you collect the information? (Check all that apply)

[ x] Web-based

[ ] E-mail

[ ] Paper mail

[ ] Other, Explain

Please make sure that all instruments, instructions, and scripts are submitted with the request.

3