State of Pennsylvania Fire and Life Safety Public Education Survey

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Supporting Statement B.doc	Supporting Statement B	Uploaded 2008-04-03	Available
Appendix G JHU Amendment cover letter.02.2008.pdf	Supplementary Document	Uploaded 2008-04-03	Available
Appendix F Non Determination.02.2008.pdf	Supplementary Document	Uploaded 2008-04-03	Available
Appendix D - 60-Day FRN.pdf	Supplementary Document	Uploaded 2008-04-03	Available
Appendix B Fire Department Invite Letter.doc	Supplementary Document	Uploaded 2008-04-03	Available
App A Legislative Authority012908.doc	Supplementary Document	Uploaded 2008-04-03	Available
Supporting Statement A.doc	Supporting Statement A	Uploaded 2008-04-03	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
184452	Pennsylvania Fire and Life Safety Education Survey	Other-WORD	New
184451	Telephone Script/Followup	Other-WORD	New

ICR Details

OMB Control No: 0920-0786	ICR Reference No: 200804-0920-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: State of Pennsylvania Fire and Life Safety Public Education Survey
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/15/2008
	Date Received in OIRA: 04/15/2008
Terms of Clearance: Approved consistent with the following terms of clearance: results of the survey will not be used to generate national level estimates related to fire/fire safety.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2010	24 Months From Approved
Responses	914	0	0
Time Burden (Hours)	163	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The propose study will involve conducting a statewide fire and life safety survey of Pennsylvania fire departments. Pennsylvania experiences a substantial burden of unintentional residential fire deaths, in 2004. The age-adusted residental fire death rate for Pennsylvania was 1:1 per 100,000 compared with anational rate of 0.96 (CDC, 2005).

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Public Health Service Act5
  

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 43642	08/06/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 18286	04/03/2008
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Telephone Script/Followup
Pennsylvania Fire and Life Safety Education Survey

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ICR Summary of Burden

table that charts list 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	914	0	0	914	0	0
Annual Time Burden (Hours)	163	0	0	163	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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: This is a new information collection.

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Annual Cost to Federal Government: $183,974

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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: 04/15/2008

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