View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 1405-0218	ICR Reference No: 202011-1405-001
Status: Historical Active	Previous ICR Reference No: 201710-1405-002
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Government, Corporate or Foundation, and Individual Donor Form Application
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: 03/26/2021
	Date Received in OIRA: 11/10/2020
Terms of Clearance: The agency made clarifying edits to the supporting statement. The agency also now allows for electronic submission via email.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2024	36 Months From Approved	03/31/2021
Responses	4,079	0	4,333
Time Burden (Hours)	680	0	361
Cost Burden (Dollars)	2,243	0	2,123

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	4,079	4,333	-254
Annual Time Burden (Hours)	680	361	319
Annual Cost Burden (Dollars)	2,243	2,123	120

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: Since the previous renewal, donations from government, individuals, corporations, and foundations slightly decreased by 6%. Donations vary due to political, environmental, and economic stability.

Annual Cost to Federal Government: $101,699

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. 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? No

Agency Contact: Chanel Wallace 202 647-7730

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