Generic PPR Submission Form - HS Collab Office Annual Report

Head Start Collab - PPR Gen IC-10-11-18.doc

Generic Performance Progress Report

Generic PPR Submission Form - HS Collab Office Annual Report

OMB: 0970-0490

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

T ITLE OF INFORMATION COLLECTION:

Head Start Collaboration Office Annual Report


PURPOSE:


This request is for an information collection that will gather uniform program performance from all 54 Head Start Collaboration Office (HSCO) grantees of which 52 are discretionary (50 states, DC, and PR) and 2 are cooperative agreements (one for American Indian and Alaska Native programs and one for Migrant and Seasonal Head Start programs).


HSCOs are awarded funds under Section 642B of the 2007 Head Start Act. HSCOs facilitate partnerships between Head Start agencies and other state entities that provide services to benefit low income children and their families. The report ascertains progress and performance results from the prior year for reporting and accountability purposes.



DESCRIPTION OF RESPONDENTS: (e.g. States or type of non-profit)


52 state or local collaboration offices and 2 collaboration offices operated by non-profits



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:_____________Jesse Escobar____________________


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


PERSONALLY IDENTIFIABLE INFORMATION:


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

  2. If Yes, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [ X ] 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

State or Local

52

1

180 minutes

156 hours

Non-profit

2

1

180 minutes

6 hours

Totals

54



162 hours


FEDERAL COST: The estimated annual cost to the Federal government is ___$14,551______


Federal staff costs are estimated to be 10% of the time of a Senior Policy Analyst to oversee information collection activities in collaboration with the HSCO and 5% of the time of a Data Analyst to be the lead for reports



TYPE OF COLLECTION:


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

[ X] Web-based

[ ] E-mail

[ ] Paper mail

[ X] Other, Explain: Fillable PDF submitted through web-based platform


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


Instructions for completing Request for Approval under the “Generic Performance Progress Report”



Program specific PPRs only need to be submitted to OMB for review and approval.


PPR instruments must display the required PRA information, i.e.,


OMB Control Number: 0970-0490; Expiration date: 1/31/2020 and the following statement:


THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13)


Public reporting burden for this collection of information is estimated to average ?? hours per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information.


An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.



TITLE OF INFORMATION COLLECTION: Provide the name of the collection that is the subject of the request.


PURPOSE: Provide a brief description of the purpose of this collection and how it will be used.


DESCRIPTION OF RESPONDENTS: Provide a brief description of the targeted group or groups for this collection of information. These groups must have experience with the program.


CERTIFICATION: Please read the certification carefully. If you incorrectly certify, the collection will be returned as improperly submitted or it will be disapproved.


PERSONALLY IDENTIFIABLE INFORMATION: Provide answers to the questions. Note: Agencies should only collect PII to the extent necessary, and they should only retain PII for the period of time that is necessary to achieve a specific objective.


BURDEN HOURS:

Category of Respondents: Identify who you expect the respondents to be in terms of the following categories: (1) Individuals or Households; (2) Private Sector; (3) State, local, or tribal governments; or (4) Federal Government. Only one type of respondent can be selected per row.

No. of Respondents: Provide an estimate of the Number of Respondents.

No. of Responses per Respondent: Provide the number of responses per respondent per year.

Burden per Response: Provide an estimate of the amount of time (in minutes) required for a respondent to participate (e.g. fill out a survey or participate in a focus group)

Burden: Provide the Annual burden hours.


FEDERAL COST: Provide an estimate of the annual cost to the Federal government.


TYPE OF COLLECTION: Check all that apply. If you are requesting approval of other instruments under the generic, you must complete a form for each instrument.



Submit all instruments, instructions, and scripts with the request.

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