View Information Collection Request (ICR) Package
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
1652-0039
ICR Reference No:
200904-1652-002
Status:
Historical Active
Previous ICR Reference No:
200606-1652-001
Agency/Subagency:
DHS/TSA
Agency Tracking No:
1652-0039
Title:
TSA Claims Management System
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
11/10/2009
Retrieve Notice of Action (NOA)
Date Received in OIRA:
08/31/2009
Terms of Clearance:
If TSA resubmits this collection for renewal they should include in the supporting statement the date of the last time any changes were made to the ICs in terms of the actual information being collected. TSA also must include the OMB control number on all of the ICs (including the supplemental forms) as well as the expiration date.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
11/30/2011
36 Months From Approved
11/30/2009
Responses
22,800
0
24,000
Time Burden (Hours)
11,400
0
6,400
Cost Burden (Dollars)
8,900
0
9,360,000
Abstract:
TSA Claims Management Office (CMO) requests certain information to investigate tort claims filed against TSA for property damage, property loss, personal injury, or death. TSA needs to collect certain information from claimants, in addition to that collected on the Standard Form 95, to investigate claims properly. TSA is seeking approval for its two supplemental forms, as well as for a pilot electronic claims system currently in development, which will ease the burden on claimants and streamline the claims process.
Authorizing Statute(s):
US Code:
28 USC 1346(b), 1402(b), 2401(b),
Name of Law: Federal Tort Claims Act
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
74 FR 14808
04/01/2009
30-day Notice:
Federal Register Citation:
Citation Date:
74 FR 29710
06/23/2009
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
TSA Claims Management System
SF 95, File 600.9.2
Claim for Damage Injury or Death
,
ATTACHMENT TO FTCA CLAIM APPROVAL LETTER
ICR Summary of Burden
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
22,800
24,000
0
0
-1,200
0
Annual Time Burden (Hours)
11,400
6,400
0
11,400
-6,400
0
Annual Cost Burden (Dollars)
8,900
9,360,000
0
-8,883,100
-468,000
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
There has been a steady decline in claims over the past three years, resulting in a decrease in burden.
Annual Cost to Federal Government:
$500,000
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
Uncollected
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
Uncollected
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Ginger LeMay 571 227-3616 ginger.lemay@dhs.gov
Common Form ICR:
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:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(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;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
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.
Certification Date:
08/31/2009
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