OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Community Services Block Grant (CSBG) Program Model Plan Applications

ICR 202005-0970-003 · OMB 0970-0382 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form 1b CSBG CARES Supplemental State Plan Form and Instruction New Available
Form 1 CSBG Model Plan Application Form and Instruction Unchanged Repair queued
Form 1 CSBG Eligible Entity Master List Form and Instruction Unchanged Repair queued
Form 1 ACSI CSBG Eligible Entity Survey Form and Instruction Unchanged Repair queued
NonSub Change Request - CSBG Supplemental State Plan - CARES Act 050520.docx Justification for No Material/Nonsubstantive Change Uploaded 2020-05-05 Repair queued
Supporting Statement OCS-0124 050520_clean.docx Supporting Statement A Uploaded 2020-05-05 Available
IM 128 Application for FY 2013 Indian Tribes and Tribal Organizations.docx Supplementary Document Uploaded 2013-05-29 Repair queued
IM 127 Application for FY 2013 State and U_S_ Territories.mht Supplementary Document Uploaded 2013-05-29 Available
IC Document Collections
IC IDCollectionTypeStatusForm
241691 CSBG CARES Supplemental State Plan Form and Instruction New
230742 CSBG Model Plan Application Form and Instruction Unchanged
230741 CSBG Eligible Entity Master List Form and Instruction Unchanged
226996 ACSI CSBG Eligible Entity Survey Form and Instruction Unchanged
ICR Details
0970-0382 202005-0970-003
Historical Active 201803-0970-002
HHS/ACF OCS
Community Services Block Grant (CSBG) Program Model Plan Applications
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 05/05/2020
Retrieve Notice of Action (NOA) 05/05/2020
  Inventory as of this Action Requested Previously Approved
06/30/2021 06/30/2021 06/30/2021
1,187 0 1,131
3,159 0 1,983
0 0 0
The Community Services Block Grant (CSBG) Model Plan Application is used as the plan submitted to ACF by States, Territories, Tribes and Tribal Organizations for the receipt of Federal funds to administer a CSBG program. The information collected is required by the CSBG Statute for the receipt of CSBG program funds. The Office of Community Services (OCS) recently received CARES Act supplemental money through the CSBG program. CSBG grantees will need to submit a state plan application to apply for supplemental funding. The supplemental state plan application is based on the approved standard CSBG State Plan application. The main difference is that the application for the supplemental has fewer questions/less information.
PL: Pub.L. 105 - 286 676 Name of Law: CSBG Program
  
None
Not associated with rulemaking
  82 FR 5438 11/17/2017
83 FR 11753 03/16/2018
Yes
  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 1,187 1,131 0 56 0 0
Annual Time Burden (Hours) 3,159 1,983 0 1,176 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
The CSBG CARES Supplemental State Plan is a supplement of the CSBG State Plan. The CSBG CARES Supplemental State Plan is a revision of the original questions in the CSBG State Plan to specifically ask the states’ (CSBG grantees) about their work as it directly relates to CSBG CARES funding.
$13,440
No
    No
    No
No
No
No
Uncollected
Molly Buck 202 205-4724 [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.
05/05/2020