View RCF - OIRA Conclusion

RCF ID: 202404-1405-001CF	Previous RCF ID:
Status: Active	Expiration Date: 03/31/2027
Agency/Subagency: STATE/AFA	Agency Tracking No:
Host OMB Control No: 1670-0052	Host ICR Reference No: 202311-1670-001

Title: Self Attestation Common Form

Type of RCF: RCF New
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/24/2024
	Date Received in OIRA: 04/24/2024
Terms of Clearance:

Description of Agency Usage: Reason for using the form is that M-22-18 requires the use of the form unless an agency wants to pursue their own form, which we do not.

Authorizing Statute(s): None

Annual Cost to Federal Government:
Agency Contact: Paul Bean 202 341-0401

Common Form Information Collections (IC) in this RCF:

IC Title	Status	Responses	Hours	Dollars	Document Type	Form No.	Form Name
Secure Software Development Attestation Form		929	2,251	0	Form and Instruction	N/A	Secure Software Sefl-Attestation Common Form

RCF Summary of Burden:

	Total Approved	Change Due to Agency Discretion
Annual Number of Responses	929	929
Annual Time Burden (Hours)	2,251	2,251
Annual Cost Burden (Dollars)	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: State is using the form because M-22-18 requires the use of the form unless an agency wants to pursue their own form, which State Department does not. We will require approximately 500 people to complete this form.