United States Park Police Personal History Statement Questionnaire

Forms and Documents

Document	Type	Status	Availability
Supporting-Statement NPS 1024-0245.doc	Supporting Statement A	Uploaded 2007-06-18	Repair queued

IC Document Collections

IC ID	Collection	Type	Status	Form
11182	US Park Police Personal History Statement Questionnaire	Other-Front Cover	Modified

ICR Details

OMB Control No: 1024-0245	ICR Reference No: 200706-1024-001
Status: Historical Active	Previous ICR Reference No: 200402-1024-001
Agency/Subagency: DOI/NPS	Agency Tracking No:
Title: United States Park Police Personal History Statement Questionnaire
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 10/18/2007
	Date Received in OIRA: 06/25/2007
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2010	36 Months From Approved	10/31/2007
Responses	600	0	600
Time Burden (Hours)	4,800	0	4,800
Cost Burden (Dollars)	0	0	0

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Abstract: The information received will be used principally as a basis for an investigation to determine an applicant's fitness for employment purposes, including a security clearance, an evaluation of qualifications, suitability, and loyalty to the United States.

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Authorizing Statute(s): US Code: 5 USC Sec. 5.2 Name of Law: Civil Service Reform Act of 1978
   US Code: 5 USC Sec.'s 1303, 1304 & 3301 Name of Law: Administrative Procedures Act
   EO: EO 10450 Name/Subject of EO: Security Requirements for Government Employees
   US Code: 42 USC Section 2455 Name of Law: Public Health and Welfare - Security Requirements
  

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:
	72 FR 19019	04/16/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 34720	06/25/2007
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
US Park Police Personal History Statement Questionnaire	USPP Form 1	United States Park Police Personal History Statement Questionnaire

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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	600	600	0	0	0	0
Annual Time Burden (Hours)	4,800	4,800	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	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:

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Annual Cost to Federal Government: $109,200

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: 06/25/2007

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