National Defense Executive Reserve Personal Qualifications Statement

ICR 199605-3067-001

OMB: 3067-0001

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
3067-0001 199605-3067-001
Historical Active 199303-3067-003
FEMA
National Defense Executive Reserve Personal Qualifications Statement
Extension without change of a currently approved collection   No
Regular
Approved without change 07/05/1996
Retrieve Notice of Action (NOA) 05/31/1996
  Inventory as of this Action Requested Previously Approved
07/31/1999 07/31/1999 07/31/1996
100 0 100
50 0 50
0 0 0

FEMA form 85-3, National Defense Executive Reserve Qualifications Statement, is used for membership as an Executive Reservist in lieu of SF-171, Application for Employment in the Federal Government.

None
None


No

1
IC Title Form No. Form Name
National Defense Executive Reserve Personal Qualifications Statement FEMA-85-3

  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 100 100 0 0 0 0
Annual Time Burden (Hours) 50 50 0 0 0 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.
05/31/1996


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