Employee Building Pass Application and File

ICR 200009-0938-010

OMB: 0938-0812

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
8600 Migrated
ICR Details
0938-0812 200009-0938-010
Historical Active
HHS/CMS
Employee Building Pass Application and File
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 11/03/2000
Retrieve Notice of Action (NOA) 09/21/2000
Approved consistent with phone call on 11/02/00. HCFA will remove OIRA's name and address in burden statement on both forms.
  Inventory as of this Action Requested Previously Approved
11/30/2003 11/30/2003
150 0 0
37 0 0
0 0 0

The purpose of this system is to control United States Government Building Passes issued to all HCFA employees and non-HCFA employees who require continuous access to HCFA buildings in Baltimore and other HCFA and HHS buildings.

None
None


No

1
IC Title Form No. Form Name
Employee Building Pass Application and File HCFA-730, HCFA-182

  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 150 0 0 150 0 0
Annual Time Burden (Hours) 37 0 0 37 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
09/21/2000


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