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:
3124-0018
ICR Reference No:
202505-3124-001
Status:
Active
Previous ICR Reference No:
Agency/Subagency:
MSPB
Agency Tracking No:
Title:
Information Collection Submission for MSPB Reasonable Accommodation Requests
Type of Information Collection:
New collection (Request for a new OMB Control Number)
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
09/16/2025
Retrieve Notice of Action (NOA)
Date Received in OIRA:
07/02/2025
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
09/30/2028
36 Months From Approved
Responses
90
0
0
Time Burden (Hours)
70
0
0
Cost Burden (Dollars)
2,653
0
0
Abstract:
This collection is part of MSPB’s compliance efforts to collect information to facilitate adjudication of reasonable accommodation requests by employees of or applicants to the MSPB, and by participants in MSPB programs, e.g., parties to appeals, respondents to surveys, etc. See The Rehabilitation Act of 1973, 29 U.S.C. 701, 791, 794; title VII of the Civil Rights Act of 1964, 42 U.S.C. 2000e; 29 CFR part 1605 (Guidelines on Discrimination Because of Religion); 29 CFR part 1614 (Federal Sector Equal Employment Opportunity); 29 CFR part 1630 (Regulations to Implement the Equal Employment Provisions of the Americans With Disabilities Act); E.O. 13164, Requiring Federal Agencies to Establish Procedures to Facilitate the Provision of Reasonable Accommodation (July 26, 2000); and E.O. 13548, Increasing Federal Employment of Individuals with Disabilities (July 26, 2010); The Pregnant Workers Fairness Act (effective June 27, 2023). Responses to any collection of information under this ICR are voluntary.
Authorizing Statute(s):
US Code:
29 USC 701
Name of Law: The Rehabilitation Act of 1973
US Code:
29 USC 791
Name of Law: The Rehabilitation Act of 1973
US Code:
29 USC 794
Name of Law: The Rehabilitation Act of 1973
US Code:
42 USC 2000e
Name of Law: Title VII of the Civil Rights Act of 1964
US Code:
42 USC 218d
Name of Law: Providing Urgent Maternal Protections for Nursing Mothers Act
US Code:
42 USC 2000gg
Name of Law: Pregnant Workers Fairness Act
EO: EO 13164 Name/Subject of EO: Requiring Federal Agencies to Establish Procedures to Facilitate the Provision of Reasonable Accommo
EO: EO 13548 Name/Subject of EO: Increasing Federal Employment of Individuals with Disabilities (July 26, 2010)
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:
90 FR 4804
01/16/2025
30-day Notice:
Federal Register Citation:
Citation Date:
90 FR 23068
05/30/2025
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
2
IC Title
Form No.
Form Name
Accommodation Request Form
N/A
Accommodation Request Form
Script for Reasonable Accommodation Submission
N/A
Script for Reasonable Accommodation Request
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
90
0
0
90
0
0
Annual Time Burden (Hours)
70
0
0
70
0
0
Annual Cost Burden (Dollars)
2,653
0
0
2,653
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
There is a burden increase because this is a new collection.
Annual Cost to Federal Government:
$201,444
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:
Gina Grippando 771 210-1650 gina.grippando@mspb.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:
07/02/2025
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