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View ICR - OIRA Conclusion

OMB Control No: 0915-0295	ICR Reference No: 202002-0915-003
Status: Historical Active	Previous ICR Reference No: 201612-0915-001
Agency/Subagency: HHS/HSA	Agency Tracking No: 20871
Title: The Division of Independent Review Application Reviewer Recruitment 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 with change	Conclusion Date: 04/14/2020
	Date Received in OIRA: 02/24/2020
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2023	36 Months From Approved	04/30/2020
Responses	9,147	0	5,250
Time Burden (Hours)	2,846	0	1,707
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	9,147	5,250	3,897
Annual Time Burden (Hours)	2,846	1,707	1,139
Annual Cost Burden (Dollars)	0	0	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: An increase in respondents has increased the burden amount. Program contacted the contractor regarding adding the public burden statement to “the top of the first page of the instrument” as requested and the response was that since we are not proprietors to the RRM system, and HRSA is not the only agency using RRM, it’s not possible to do that at this time.

Annual Cost to Federal Government: $6,160

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. No

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. No

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: Elyana Bowman 301 443-3983 enadjem@hrsa.gov

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