General Admissions Application (Long and Short) and Stipend Forms

Forms and Documents

Document Name	Status
Form 75-5 General Admissions Application (Long) Form Form	Modified
Form FF 95-22 Executive Fire Officer program Application for Admission Form and Instruction	New
Form FF 75-3 Student Stipend Agreement Form and Instruction	New
Form FF 75-5 (automated General Admissions Application - Automated Form and Instruction	New
Form FF 75-5a ( automat General Admissions Application - Short Form Automated Form and Instruction	New
Form FF 75-5a General Admissions Application - Short Form Form and Instruction	New
PL 93-498.pdf Supplementary Document	1974-10-29
PUBLISHED 30 Day Notice.pdf Supplementary Document	2007-02-27
NFA Supporting Statement A FINAL[1].DOC Supporting Statement A	0000-00-00
NETC Admissions System Requirements.doc Supplementary Document	2006-10-30
PL 106-390.doc Supplementary Document	2000-10-30
PUBLISHED 60 day notice.pdf Supplementary Document	2006-10-24
Privacy Impact Assessment 9-28-04.doc Supplementary Document	2004-09-28

IC Document Collections

IC ID	Document Title	Status
21048	General Admissions Application (Long) Form Form	Modified
178881	Executive Fire Officer program Application for Admission Form and Instruction	New
178878	Student Stipend Agreement Form and Instruction	New
178877	General Admissions Application - Automated Form and Instruction	New
178876	General Admissions Application - Short Form Automated Form and Instruction	New
178874	General Admissions Application - Short Form Form and Instruction	New

ICR Details

OMB Control No: 1670-0002	ICR Reference No: 200702-1670-006
Status: Historical Active	Previous ICR Reference No: 200609-1670-004
Agency/Subagency: DHS/CISA	Agency Tracking No:
Title: General Admissions Application (Long and Short) and Stipend Forms
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/18/2007
	Date Received in OIRA: 02/28/2007
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2010	36 Months From Approved	05/31/2007
Responses	108,040	0	205,000
Time Burden (Hours)	11,167	0	34,166
Cost Burden (Dollars)	0	0	727,500,000

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Abstract: Courses offered by the National Fire Academy and Emergency Management Institute enhance job performance and provide networking opportunities for fire and emergency management personnel to better respond to disasters. Students may be eligible for college credits after completion of certain courses.

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Authorizing Statute(s): EO: EO 12148 Name/Subject of EO: Federal Emergency Management
   EO: EO 12127 Name/Subject of EO: Federal Emergency Management Agency
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	71 FR 62274	10/24/2006
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 8760	02/27/2007
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 6

IC Title	Form No.	Form Name
General Admissions Application - Short Form	FF 75-5a	General Admissions Applications - Short Form
General Admissions Application - Short Form Automated	FF 75-5a ( automated)	General Admissions Application - Short Form
General Admissions Application - Automated	FF 75-5 (automated)	General Admissions Application
Student Stipend Agreement	ff75-3a, FF 75-3	Student Stipend Agreement ,   Student Stipend Agreement Amendment
Executive Fire Officer program Application for Admission	FF 95-22	National Fire Academy - Executive Fire Officer Application for Admissions
General Admissions Application (Long) Form	75-5	General Admissions Application

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ICR Summary of Burden

	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	108,040	205,000	0	0	-96,960	0
Annual Time Burden (Hours)	11,167	34,166	0	0	-22,999	0
Annual Cost Burden (Dollars)	0	727,500,000	0	0	-727,500,000	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The National Fire Administration has put all of its forms online. These forms will be able to be filled out and electronically submitted in the future. Burdens for several forms changed. For FF 75-5 there was increase of 750 hours. For form 75-5a there was an increase of 3500 hours. For the automated form 75-5 there was a decrease of 1250 hours. The Student Stipend paper-only forms; 75-3 and 75-3a decreased for a total of 6566 hours. The students only need to provide a copy of a cancelled check and confirm the information already provided on the form by NFA by signing the document. FF95-22 is new and has an increase of 67 hours. The 75-3 and the 75-3a do not include burden statements becuase the NFA fills out all of the information except the signature blocks.

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Annual Cost to Federal Government: $652,500

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

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Common Form ICR:  No

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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: 02/28/2007

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