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OMB Control No: 0584-0686	ICR Reference No: 202605-0584-001
Status: Received in OIRA	Previous ICR Reference No: 202303-0584-002
Agency/Subagency: USDA/FNS	Agency Tracking No:
Title: FNS 775 EmpowHR/Person Model Non-Employee Data Sheet
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 08/28/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	09/30/2026
Responses	750	750
Time Burden (Hours)	375	375
Cost Burden (Dollars)	0	0

Abstract: The collection of the data such as full legal name, address, phone, social security number, birthdate, place of birth, country of citizenship is required to input into the USDA system of record, Empower Human Resources (EmpowHR), so that upon submission, it conforms to the data requirements set forth by USAccess. Please see Appendix B FNS 775 EmpowHR/Person Model which shows the required biographic data to be collected for system input. Legal authority for gathering of data fields mentioned above comes from the Homeland Security Presidential Directive 12 (Appendix A Legal Authority). The Directive references HSPD-12 as the chosen standard for data collection for employees and contractors. HSPD-12 was issued on August 12, 2004 and calls for a mandatory, government-wide standard for secure and reliable ID for all of its employees and contractors to access federally-controlled facilities and networks. Based upon this directive, the National Institute for Standards and Technology (NIST) developed Federal Information Processing Standards Publication (FIPS Pub) 201. USDA’s LincPass card is designed to link a person’s identity to an ID credential and the credential to a person’s ability to physically and logically access federally controlled buildings and information systems, respectively. Authorizing statute includes 731.106(c)(2).

Authorizing Statute(s): None

Citations for New Statutory Requirements: PL: Pub.L. 104 - 193 346 Name of Law: Department of Agriculture Personal Responsibility and Work Opportunity Reconciliation Act of 1996

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:
	91 FR 35951	06/16/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 55319	08/27/2026
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
Business (Contractors)	FNA-775
Individuals/Households	FNA 775

ICR Summary of Burden

	Total Request	Previously Approved
Annual Number of Responses	750	750
Annual Time Burden (Hours)	375	375
Annual Cost Burden (Dollars)	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: $2,197,308

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: Jamia Franklin 703 305-2403 jamia.franklin@usda.gov

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