Client Service Use and Delivery

Domestic Victims of Human Trafficking (DVHT) Program Data

Documents and Forms

Document Name Document Type
Form 4 Client Service Use and Delivery Form
4 FY25 DVHT Performance Indicators FY25 DVHT Performance Indicators - clean _v2.docx Form
FY25 DVHT Reporting Reference Guide - clean_v2.docx Instruction
4b Reporting Workbook - For use if unable to report in ATIMS FY25 DVHT Reporting Workbook_For Use Only If Recipient Unable to Report in ATIMS_v2.xlsx Form and Instruction

Information Collection (IC) Details

IC Title:	Client Service Use and Delivery	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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	4	FY25 DVHT Performance Indicators	FY25 DVHT Performance Indicators - clean _v2.docx	Yes	Yes	Fillable Fileable
Instruction			FY25 DVHT Reporting Reference Guide - clean_v2.docx	Yes	Yes	Printable Only
Form and Instruction	4b	Reporting Workbook - For use if unable to report in ATIMS	FY25 DVHT Reporting Workbook_For Use Only If Recipient Unable to Report in ATIMS_v2.xlsx	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 900	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	300	-267	567
Annual IC Time Burden (Hours)	75	-67	142
Annual IC Cost Burden (Dollars)	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.