OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Senior Corps Independent Living Surveys and Performance Measure Aggregation Tool

ICR 201701-3045-001 · OMB 3045-0152 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form 1 Independent Living Performance Measures Aggregation Tool Form Modified Repair queued
SCP PM Data Aggregation Tool Justification FINAL.doc Supporting Statement A Uploaded 2017-04-07 Available
IC Document Collections
IC IDCollectionTypeStatusForm
207237 Independent Living Performance Measures Aggregation Tool Form Modified
ICR Details
3045-0152 201701-3045-001
Historical Active 201306-3045-001
CNCS
Senior Corps Independent Living Surveys and Performance Measure Aggregation Tool
Reinstatement with change of a previously approved collection   No
Regular
Approved with change 04/11/2017
Retrieve Notice of Action (NOA) 01/12/2017
  Inventory as of this Action Requested Previously Approved
04/30/2020 36 Months From Approved
53,470 0 0
26,735 0 0
0 0 0
Senior Corps adopted new, required performance measures for its programs beginning in Fiscal Year 2013. Under a separate information collection approval, two Independent Living Performance Measures Surveys were cleared for use by grantees of the Senior Companion Program (required) and the RSVP Program (optional). This information collection requests adds the surveys to the aggregation tool as additional instruments. The Independent Living Performance Measures Aggregation Tool will serve as the required template for grantees to use to provide two levels of information: (1) A row on the spreadsheet template corresponding to each individual client, without any personal information that could identify the individual; and (2) aggregate project level performance measures data for submission to CNCS.
US Code: 42 USC 12501 et seq Name of Law: National Community Service Law of 1994 as amended
  
None
Not associated with rulemaking
  81 FR 31612 05/19/2016
82 FR 3759 01/12/2017
No
1
IC Title Form No. Form Name
Independent Living Performance Measures Aggregation Tool 2, 3, 1 Data Aggregation Tool ,   Independent Living Survey ,   Respite Survey
  Total Approved 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 53,470 0 0 53,120 0 350
Annual Time Burden (Hours) 26,735 0 0 24,285 0 2,450
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
The burden has increased because we have incorporated the instruments from a previously cleared information collection request into this clearance for the aggregation tool.
$0
No
No
No
No
No
Uncollected
Amy Borgstrom 202 606-6930 [email protected]
  No
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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
01/12/2017