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:
2105-0009
ICR Reference No:
201808-2105-004
Status:
Historical Active
Previous ICR Reference No:
200903-2105-002
Agency/Subagency:
DOT/OST
Agency Tracking No:
2105-0009
Title:
Advisory Committee Candidate Biographical Information Request
Type of Information Collection:
Reinstatement without change of a previously approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
02/14/2019
Retrieve Notice of Action (NOA)
Date Received in OIRA:
12/11/2018
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
02/28/2022
36 Months From Approved
Responses
100
0
0
Time Burden (Hours)
25
0
0
Cost Burden (Dollars)
0
0
0
Abstract:
The collection is necessary to gather information from individuals interested in appointments to advisory committees and individuals who have been recommended for membership on an advisory committee to ensure that the committee is balanced and fairly and equitably represents, to the extent feasible, all the various interests that may be affected by the committees work and that undue weight not be afforded the views of any one interest, as required by the Federal Advisory Committee Act, P.L. 92-463. Responding to the collection is voluntary and is not required to obtain or retain a benefit. Respondents are members of the public who wish to serve on DOT committees. The collection is not for reporting or record-keeping. It is for disclosure of information to conduct a background check. The information is collected when they are first nominated and then upon re-appointment (if applicable). Disclosure of information is for conducting a background check. The information will be received by the Committee Management and contractor that will conduct the background check. The purpose of the collection is to vet any candidate that will serve on a DOT committee. This ICR is not a revision.
Authorizing Statute(s):
PL:
Pub.L. 93 - 579 Section 2
Name of Law: The Privacy Act of 1974
PL:
Pub.L. 92 - 463 Section 10-12
Name of Law: Federal Advisory Committee 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:
83 FR 27080
06/11/2018
30-day Notice:
Federal Register Citation:
Citation Date:
83 FR 44693
08/31/2018
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
Advisory Committee Candidate Biographical Information Request
DOT F 1120.1
Advisory Committee Candidate Biographical Information Request
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
100
0
0
0
0
100
Annual Time Burden (Hours)
25
0
0
0
0
25
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Annual Cost to Federal Government:
$0
Does this IC contain surveys, censuses, or employ statistical methods?
No
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
Yes
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
Yes
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
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:
David Freeman 202 366-2918 david.w.freeman@dot.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:
12/11/2018
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