PERSONAL HISTORY STATEMENT FOR POSSIBLE NOMINATION TO AN ADVISORY COMMITTEE

ICR 197912-0605-001

OMB: 0605-0003

Federal Form Document

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Document
Name
Status
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IC Document Collections
ICR Details
0605-0003 197912-0605-001
Historical Active 197601-0605-001
DOC/ADMIN
PERSONAL HISTORY STATEMENT FOR POSSIBLE NOMINATION TO AN ADVISORY COMMITTEE
Revision of a currently approved collection   No
Regular
Approved without change 12/19/1979
Retrieve Notice of Action (NOA) 12/05/1979
  Inventory as of this Action Requested Previously Approved
09/30/1984 09/30/1984 12/31/1979
500 0 3,000
125 0 750
0 0 0

INFORMATION USED BY THE COMMERCE DEPARTMENT IN ITS EVALUATION AND ADMINISTRATIVE CLEARANCE OF INDIVIDUALS BEING CONSIDERED FOR SELECTION TO AN ADVISORY COMMITTEE. RESPONSIBLE AGENCY OFFICIAL IS YVONNE BARNS, MAIN COMMERCE BUILDING, ROOM 5319, 377-4217

None
None


No

1
IC Title Form No. Form Name
PERSONAL HISTORY STATEMENT FOR POSSIBLE NOMINATION TO AN ADVISORY COMMITTEE CD-555

  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 500 3,000 0 0 -2,500 0
Annual Time Burden (Hours) 125 750 0 0 -625 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
12/05/1979


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