E-Appeal/US Merit Systems Protection Board Appeal Form

ICR 200612-3124-001

OMB: 3124-0009

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supporting Statement A
2006-12-21
Supplementary Document
2006-12-21
IC Document Collections
IC ID
Document
Title
Status
32657 Modified
ICR Details
3124-0009 200612-3124-001
Historical Active 200310-3124-001
MSPB
E-Appeal/US Merit Systems Protection Board Appeal Form
Revision of a currently approved collection   No
Regular
Approved with change 06/11/2007
Retrieve Notice of Action (NOA) 12/22/2006
This information collection request is approved as submitted, except for the request to collect the last 4 digits of an appellant's SSN, which is not approved. MSPB will delete this question prior to re-issuing this form.
  Inventory as of this Action Requested Previously Approved
06/30/2010 36 Months From Approved 06/30/2007
7,150 0 6,300
7,150 0 6,300
0 0 0

This is a voluntary form completed by persons who file appeals with the U.S. Merit Systems Protection Board. The form serves as a guide to appellants in providing all needed information. It is available both as a static form, which is available on our website and upon request, and as an online interactive application.

US Code: 5 USC 1204, 1221, 3330a, 7701 Name of Law: Civil Service Reform Act and others
  
None

Not associated with rulemaking

  71 FR 55221 09/21/2006
71 FR 75277 12/14/2006
Yes

1
IC Title Form No. Form Name
E-Appeal/US Merit Systems Protection Board Appeal Form MSPB-185 MSPB Form 185

  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 7,150 6,300 0 0 850 0
Annual Time Burden (Hours) 7,150 6,300 0 0 850 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
The annual number of responses has increased since the last approval from 6,300 to 7,150. This reflects an increased number of persons who file appeals with the MSPB. The Board has no control over the number of appeals filed, which has remained relatively stable over the years.

$27,390
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Timothy Korb 202-653-6772 ext. 1230 [email protected]

  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.
12/22/2006


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