Application for Employment with the Federal Aviation Administration

Forms and Documents

Document Name	Status
Form OPM-1170 Application for Employment with the Federal Aviation Administration Form	Modified
2120-0597 2006.doc Supporting Statement A	2006-12-14

IC Document Collections

IC ID	Document Title	Status
25678	Application for Employment with the Federal Aviation Administration Form	Modified

ICR Details

OMB Control No: 2120-0597	ICR Reference No: 200610-2120-004
Status: Historical Inactive	Previous ICR Reference No: 200308-2120-006
Agency/Subagency: DOT/FAA	Agency Tracking No:
Title: Application for Employment with the Federal Aviation Administration
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Improperly submitted and continue	Conclusion Date: 01/17/2007
	Date Received in OIRA: 12/22/2006
Terms of Clearance: This information collection request is being returned as improperly submitted due to failure to certify. When resubmitting to OMB, please 1) certify the collection, 2) clarify whether the FAA is requesting an extension (as stated in section A1) or a revision (as stated on the ROCIS worksheet)—if FAA is requesting a revision, please provide a summary of changes, 3) verify that the costs to the federal government amount given in section A 14 is consistent with the amount reported on the ROCIS worksheet, amend the ROCIS worksheet if necessary, and 4) provide a more detailed explanation in section A17 to support the request not to display an OMB control number.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2006	36 Months From Approved	04/30/2007
Responses	50,000	0	50,000
Time Burden (Hours)	75,000	0	75,000
Cost Burden (Dollars)	0	0	0

---

Abstract: This collection of information is necessary for gathering data concerning potential new hires for the FAA. The information will be used to evaluate the qualifications of applicants for a variety of positions. Without this information there would be no reliable means to accurately evaluate applicants' skills, knowledge, and abilities to perform the duties of these positions.

---

Authorizing Statute(s): PL: Pub.L. 104 - 50 348 Name of Law: Department Of Transportation Appropriations Act
  

Citations for New Statutory Requirements: None

---

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:
	71 FR 45092	08/08/2006
30-day Notice:	Federal Register Citation:	Citation Date:
	71 FR 63828	10/31/2006
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Application for Employment with the Federal Aviation Administration	3330-42, 3330-52, OF 304, 3330-43-1, AF-SRG-005, AF-SRG-002, 3330-43, AF-SRG-001, OPM 1635, 54972, AC-3300-70, 3330-473, AF-SRG-007, 3330-71, ASG-MFG-001, OF 612, SF 15, AF-SRG-004, OPM-1170, AF-SRG-003, AF-SRG-006, AF 3330.1A, 52569, FTP 001, 2105-0557	List of College Courses and Certification of Scholastic Achievement ,   Welfare To Work Program ,   Air Traffic Control Specialist (Center/Terminal) AT-2152-AG Geographic Preferences ,   Standardized Ranking Factors for Airway Transportation Systems Specialist, GS-2101-14/15 ,   Application for Employment with the Federal Aviation Administration ,   Standarized Ranking Factors for Engineering Technician, GS-082-11/12/13 ,   Rating of Air Traffic Experience ,   Standardized Ranking Factors for Engineering Technician, GS-802-5/7/9 ,   Supplemental Qualifications Statement for 1825 and 2181 Series ,   Air Traffic National Selection System (ATNSS) Application Form Package ,   Aviation Safety Inspector (Manufacturing) Supplemental Questionnaire ,   Application for Emplyment with the Federal Aviation Administration ,   Standardized Ranking Factors for Electronics Technician, GS-856-5/7/9 ,   AFMSP Application Sheet ,   Standardized Ranking Factors for Electronics Technician, GS-856-11/12/13 ,   Request for Promotion Consideration and Acknowledgement ,   Knowlegdes, Skills, Abilities, and Other Characteristics (KSAO's) Evaluation ,   Optional Application for Federal Employment ,   Application for 10-Point veteran Preference ,   Standardized Ranking Factors for Airway Transporation Systems Specialist, GS-2101-11/12/13 ,   Standarized Ranking Factors for Airway Transportation Systems Specialist, GS-2101-5/7/9 ,   Flight Test Pilot Supplemental Questionnaire ,   US Department of Transportation Applicant Background Questionnaire ,   Declaration for Federal Employment ,   Rating of Air Traffic Experience for AT Movement

---

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: The burden increase is based on the number of applicants increasing since the last reporting period.

---

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 12/22/2006

---