View Information Collection Request (ICR) Package
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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:
1405-0204
ICR Reference No:
202211-1405-002
Status:
Active
Previous ICR Reference No:
201902-1405-007
Agency/Subagency:
STATE/AFA
Agency Tracking No:
Title:
Risk Analysis and Management(RAM)
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
03/13/2023
Retrieve Notice of Action (NOA)
Date Received in OIRA:
11/16/2022
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
03/31/2026
36 Months From Approved
03/31/2023
Responses
500
0
500
Time Burden (Hours)
750
0
750
Cost Burden (Dollars)
0
0
0
Abstract:
The Risk Analysis Information form is a supplementary form for security screening that will be completed by organizations, entities or individuals applying for Department of State contracts, grants or other funding. Data collected includes the name, date and place of birth, gender, citizenship(s), U.S. passport or Social Security number if US citizen or Legal Permanent Resident, address, telephone and fax numbers, e-mail address, and current employer and job title of each of the "key personnel" of the organization. The information will be entered into government and public databases for screening to ensure that any funds awarded will not be purposefully or inadvertently used to provide support to entities or individuals deemed to be a risk to national security. The statutes and regulations authorizing the collection of information are: 18 U.S.C. 2339A, 2339B, 2339C; 22 U.S.C.2151 et seq.; Section 559 of the FY06 Foreign Operations Appropriations Act, Executive Orders 13224, 13099 and 12947; and Homeland Security Presidential Directive 6.
Authorizing Statute(s):
US Code:
18 USC 2339A
Name of Law: Providing Material Support to Terrorists
US Code:
18 USC 2339B
Name of Law: Providing Material Support or Resources to Designated Foreign Terrorist Organizations
US Code:
18 USC 2339C
Name of Law: Prohibitions Against the Financing of Terrorism
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:
87 FR 52102
08/25/2022
30-day Notice:
Federal Register Citation:
Citation Date:
87 FR 67740
11/09/2022
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
Risk Management and Analysis (RAM)
DS-4184
Risk Analysis Information
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
500
500
0
0
0
0
Annual Time Burden (Hours)
750
750
0
0
0
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:
$2,700,000
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:
Brandi Beam 202 394-5151 beambm@state.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:
11/16/2022
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