View Information Collection Request (ICR) Package

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: 3076-0004	ICR Reference No: 202203-3076-003
Status: Historical Active	Previous ICR Reference No: 202009-3076-011
Agency/Subagency: FMCS	Agency Tracking No:
Title: Notice to Mediation Agency
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: 05/23/2022
	Date Received in OIRA: 04/22/2022
Terms of Clearance: At the next renewal, we appreciate efforts by FMCS to estimate any changes in burden for the public as a result of nonsubstantive streamlining efforts.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2024	11/30/2024	11/30/2024
Responses	16,000	0	16,000
Time Burden (Hours)	2,667	0	2,667
Cost Burden (Dollars)	0	0	0

Annual Cost to Federal Government: $471,000

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? No

Agency Contact: Anna Davis 202 606-3737 adavis@fmcs.gov

Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.