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Client Characteristics and Program Entry
Domestic Victims of Human Trafficking (DVHT) Program Data
OMB: 0970-0542
IC ID: 239400
OMB.report
HHS/ACF
OMB 0970-0542
ICR 202310-0970-012
IC 239400
( )
Documents and Forms
Document Name
Document Type
Form 1
Client Characteristics and Program Entry
Form
FY24 DVHT Reporting Reference Guide_Clean.docx
Instruction
1 Client Characteristics and Program Entry Form
FY24 DVHT Performance Indicators_Clean.docx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Client Characteristics and Program Entry
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
1
Client Characteristics and Program Entry Form
FY24 DVHT Performance Indicators_Clean.docx
Yes
Yes
Fillable Fileable
Instruction
FY24 DVHT Reporting Reference Guide_Clean.docx
Yes
Yes
Printable Only
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:
1,700
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
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
567
0
0
0
0
567
Annual IC Time Burden (Hours)
425
0
0
0
0
425
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.