View Information Collection Request (ICR) Package
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Common Form Info.
Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
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:
1090-0009
ICR Reference No:
201809-1090-001
Status:
Historical Active
Previous ICR Reference No:
201509-1090-001
Agency/Subagency:
DOI/ASPMB
Agency Tracking No:
Title:
Donor Certification Form
Type of Information Collection:
Extension without change of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
12/14/2018
Retrieve Notice of Action (NOA)
Date Received in OIRA:
10/23/2018
Terms of Clearance:
In accordance with 5 CFR 1320, the information collection is approved for three years.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
12/31/2021
36 Months From Approved
12/31/2018
Responses
115
0
250
Time Burden (Hours)
39
0
84
Cost Burden (Dollars)
0
0
0
Abstract:
The Department of the Interior and its bureaus (Department or DOI) has various authorities that permit the acceptance of donations or gifts in furtherance of resource conservation projects and other programs. Before accepting a donation, DOI must first evaluate whether or not the circumstances of the donation maintain the integrity of the Department's programs and operations, the impartiality of the Department, and public confidence in the Department. Prior to enacting the Donations Policy, DOI conducted a risk analysis in which $25,000 was determined to be the threshold above which there was a greater risk of possible legal or ethical questions associated with donations. Therefore, for donations valued at $25,000 or more, donors are requested to complete a DI-3680 Donor Certification form (DI-3680 form) to provide information clarifying business and legal interactions with the Department and consistency with the Donations Policy prior to acceptance.
Authorizing Statute(s):
Statute at Large:
9 Stat. 395
Name of Statute: An Act to Establish the Home Department
US Code:
18 USC 201
Name of Law: Bribery, Graft, and Conflicts of Interest
US Code:
16 USC 460/-1h
Name of Law: Outdoor Recreation Authority - Donations
US Code:
16 USC 4601-4608
Name of Law: Take Pride in America Program
US Code:
25 USC 5341
Name of Law: Donations for Indians; use of gifts
US Code:
25 USC 2006
Name of Law: BIE Accepting Gifts
US Code:
43 USC 1701 and 1737c
Name of Law: Federal Land Policy and Management Act of 1976 (FLPMA)
US Code:
43 USC 395
Name of Law: BOT - Acceptance of Non-Federal Funds
US Code:
16 USC 661
Name of Law: Partnerships for Fish and Wildlife
US Code:
16 USC 3741
Name of Law: Partnerships for Wildlife Program
US Code:
16 USC 3701
Name of Law: Cooperation with the National Fish and Wildlife Foundation
US Code:
43 USC 36a-c
Name of Law: USGS - Gift and General Cooperation Authority
US Code:
43 USC 1473
Name of Law: BOEM - Gift Authority
US Code:
54 USC 101101
Name of Law: General Authority for NPS to Accept Donations
US Code:
54 USC 307107
Name of Law: Donations and Bequests of Money, Personal Property and Less than Fee Interests in Historic Property
US Code:
30 USC 1231b3
Name of Law: Abandoned Mine Reclamation Fund
US Code:
16 USC 3192
Name of Law: ANILCA - Land acquisition authority
US Code:
16 USC 3196
Name of Law: ANILCA - Administrative sites and visitor facilities
US Code:
54 USC 200103(i)
Name of Law: Authority of the Secretary to Carry out Certain Functions and Activities
US Code:
54 USC 101111
Name of Law: Donations to the National Park Foundation (NPF) for the Benefit of NPS
US Code:
54 USC 102503(b)
Name of Law: Donations for Museum Purposes
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 20852
05/08/2018
30-day Notice:
Federal Register Citation:
Citation Date:
83 FR 53291
10/22/2018
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
3
IC Title
Form No.
Form Name
Businesses and Organizations
DI-3680
Donor Certification Form
Individuals and Households
DI-3680
Donor Certification Form
State, Local or Tribal Government
DI-3680
Donor Certification Form
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
115
250
0
0
-135
0
Annual Time Burden (Hours)
39
84
0
0
-45
0
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:
$18,495
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:
Jeffrey Parrillo 202 208-7072 jeffrey_parrillo@ios.doi.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:
10/23/2018
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