Technology Clearinghouse National Online Electronic Assessment

Forms and Documents

Document Name	Status
Form DHs Form 10054 (5/ Exit Form Form and Instruction	New
Form DHS Form 10053 (5/ Structured Assessment Case Free Form Query Form and Instruction	New
Form DHS Form 10052 (5/ Structured Assessment Case #2 Form and Instruction	New
Form DHS Form 10051 (5/ Structured Assessment Case #1 Form and Instruction	New
Form DHS Form 10050 (5/ Entrance Form Form and Instruction	New
Form DHS Form 10049 (5/ Consent Form Form and Instruction	New
Supporting Statement B - Tech Clearinghouse.doc Supporting Statement B	2008-08-01
Supporting Statement A - Tech Clearinghouse.doc Supporting Statement A	2008-08-01
Tech Clearinghouse 30-day notice.pdf Supplementary Document	2008-08-01
60-day notice-publication.pdf Supplementary Document	2008-07-17
PTA ST Tech Clearinghouse 20070917 PRIV Final.pdf Supplementary Document	2008-07-17

IC Document Collections

IC ID	Document Title	Status
185981	Exit Form Form and Instruction	New
185980	Structured Assessment Case Free Form Query Form and Instruction	New
185979	Structured Assessment Case #2 Form and Instruction	New
185977	Structured Assessment Case #1 Form and Instruction	New
185976	Entrance Form Form and Instruction	New
185975	Consent Form Form and Instruction	New

ICR Details

OMB Control No: 1640-0014	ICR Reference No: 200807-1640-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DHS/S&T	Agency Tracking No:
Title: Technology Clearinghouse National Online Electronic Assessment
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: 10/30/2008
	Date Received in OIRA: 08/18/2008
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2011	36 Months From Approved
Responses	700	0	0
Time Burden (Hours)	250	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Homeland Security Act of 2002 requires the Department of Homeland Security (DHS) Science and Technology Directorate (S&T) to establish a Technology Clearinghouse to encourage and support innovative technical solutions to enhance homeland security and the mission of the Department (P.L. 107-296, Section 313). This requirement responds to long-standing requests by the first responder community to create a resource for information and technology that would assist them in support of their mission. In order to assess the current version of the DHS Tech Clearinghouse, a National Online Electronic Assessment will be administered.

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Authorizing Statute(s): PL: Pub.L. 107 - 296 313 Name of Law: Homeland Security Act of 2002
  

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:
	73 FR 28831	05/19/2008
30-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 45026	08/01/2008
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
Entrance Form	DHS Form 10050 (5/08)	Entrance Form
Structured Assessment Case #1	DHS Form 10051 (5/08)	Structured Assessment Case #1
Structured Assessment Case Free Form Query	DHS Form 10053 (5/08)	Structured Assessment Case: Free Form Query
Exit Form	DHs Form 10054 (5/08)	Exit Form
Consent Form	DHS Form 10049 (5/08)	Consent Form
Structured Assessment Case #2	DHS Form 10052 (5/08)	Structured Assessment Case #2

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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	700	0	0	700	0	0
Annual Time Burden (Hours)	250	0	0	250	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: The increase in burden occured due to the program need to assess the technology clearinghouse website in order to improve its utility to first responders nationwide.

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Annual Cost to Federal Government: $10,000

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: 08/18/2008

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