GRR Submission Form - OPRE

Request for Approval under the “Generic Clearance for the Collection of Grant Reviewer Recruiter Forms” (OMB Control Number: 0970-0477)

TITLE OF INFORMATION COLLECTION: PURPOSE:

Collect eligibility information from applicants to become ACF grant reviewers.

DESCRIPTION OF RESPONDENTS:

Applicants to become ACF grant reviewers.

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

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.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

7. The information collection does not employ statistical methods. _Name: Wendy DeCourcey

BURDEN HOURS (Annual Bases)

Category of Respondent	No. of Respondents	Participation Time	Burden
Reviewers Generally Interested (Generic Reviewer Information Collection)	15	10	2.5
Reviewers Interested in Specific Reviews (Specific Reviews Information Collection)	80	10	13.33
Totals	95	20	15.83

FEDERAL COST: The estimated annual cost to the Federal government is

2600.00

Administration of the Instrument

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

   • Web-based or other forms of Social Media

Telephone In-person Mail

• Other, Explain

-email with attached fillable document or with link to survey monkey

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

2