View Information Collection Request (ICR) Package
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View Information Collection (IC) List
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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:
3060-1246
ICR Reference No:
202306-3060-003
Status:
Active
Previous ICR Reference No:
202006-3060-010
Agency/Subagency:
FCC
Agency Tracking No:
OWD
Title:
Reasonable Accommodation Requests, FCC Forms 5626 and 5627
Type of Information Collection:
Extension without change of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Delegated
OIRA Conclusion Action:
Approved without change
Conclusion Date:
06/22/2023
Retrieve Notice of Action (NOA)
Date Received in OIRA:
06/22/2023
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
06/30/2026
36 Months From Approved
07/31/2023
Responses
36
0
108
Time Burden (Hours)
98
0
284
Cost Burden (Dollars)
3,400
0
3,400
Abstract:
This information, completed on FCC Form 5626 and FCC Form 5637 will be used by the OWD to process, track, and maintain the confidentiality of reasonable accommodation requests.
Authorizing Statute(s):
US Code:
29 USC 794
EO: EO 13164 Name/Subject of EO: EEOC Policy GuidanceEstablishing Procedures to Facilitate the Provision of Reasonable Accommodation.
US Code:
29 USC 791
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:
88 FR 24420
04/20/2023
30-day Notice:
Federal Register Citation:
Citation Date:
88 FR 24420
04/20/2023
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
2
IC Title
Form No.
Form Name
Federal Government
FCC Form 5626
Reasonable Accommodation Form with Questionnaire
Individuals or Households
FCC Form 5627
Medical Consent Form
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
36
108
0
0
-72
0
Annual Time Burden (Hours)
98
284
0
0
-186
0
Annual Cost Burden (Dollars)
3,400
3,400
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:
The Commission is reporting adjustments to this information collection. The total number of respondents decreased by -36, the total annual responses decreased by -72, and the total annual burden hours decreased by -186 hours. These calculations are based on the most currently available data to the Commission. It is important to note that the COVID-19 pandemic and the Commission's extended telework status contributed to fewer requests for reasonable accommodations, which in turn led to the reported adjustments. There are no program changes.
Annual Cost to Federal Government:
$42,503
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:
Jedidiah Gibson 202 418-1080 jedidiah.gibson@fcc.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:
06/22/2023
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