View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 3015-0007	ICR Reference No: 202202-3015-004
Status: Historical Active	Previous ICR Reference No: 201906-3015-012
Agency/Subagency: DFC	Agency Tracking No: DFC‐005
Title: Personal Financial Statement
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/18/2022
	Date Received in OIRA: 02/18/2022
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2022	08/31/2022	08/31/2022
Responses	75	0	75
Time Burden (Hours)	75	0	75
Cost Burden (Dollars)	5,625	0	5,625

ICR Summary of Burden

	Total Approved	Previously Approved
Annual Number of Responses	75	75
Annual Time Burden (Hours)	75	75
Annual Cost Burden (Dollars)	5,625	5,625

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: This is a new information collection

Annual Cost to Federal Government: $4,211

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. 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? No

Agency Contact: Jameka Carter 202 336-8430 jameka.carter@opic.gov

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