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: 3206-0269	ICR Reference No: 202211-3206-005
Status: Historical Inactive	Previous ICR Reference No: 201909-3206-002
Agency/Subagency: OPM	Agency Tracking No: OPM 1647
Title: Combined Federal Campaign
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Improperly submitted and continue	Conclusion Date: 01/04/2023
	Date Received in OIRA: 11/30/2022
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2022	36 Months From Approved	07/31/2024
Responses	8,000	0	8,000
Time Burden (Hours)	1,066,667	0	1,066,667
Cost Burden (Dollars)	172,000	0	172,000

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Combined Federal Camp	OPM 1647 A, OPM 1647 B, OPM 1647 E	, ,
Combined Federal Campaign	OPM Form 1647 E, OPM Form 1647 A, OPM Form 1647 B	, ,

Annual Cost to Federal Government: $59,850

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: Charles Conyers 202 606-0125 charles.conyers@opm.gov

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