Application for Digital-to-Analog Converter Box Coupons for Nursing Home Residents

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Application for Digital-to-Analog Converter Box Coupons for Nursing Home Residents	Form and Instruction	Modified	Available
0660.NursingHomes.SuppStmt.082808.doc	Supporting Statement A	Uploaded 2008-08-29	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
184582	Application for Digital-to-Analog Converter Box Coupons for Nursing Home Residents	Form and Instruction	Modified

ICR Details

OMB Control No: 0660-0027	ICR Reference No: 200809-0660-002
Status: Historical Active	Previous ICR Reference No: 200808-0660-003
Agency/Subagency: DOC/NTIA	Agency Tracking No:
Title: Application for Digital-to-Analog Converter Box Coupons for Nursing Home Residents
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: 09/19/2008
	Date Received in OIRA: 09/19/2008
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2011	36 Months From Approved
Responses	414,000	0	0
Time Burden (Hours)	138,000	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: As directed by Congress, NTIA implemented a program to provide consumers with continued over-the-air broadcast programming using analog-ony television sets. To achieve this, the use of digital-to-analog converter boxes is required. NTIA began accepting converter box applications on January 1, 2008. NTIA received many applications submitted by, or on behalf of, individuals living in nursing homes. Nursing homes are not considered households as defined in the current regulations and therefore the residents are not eligible to receive coupons. A Notice of Proposed Rulemaking was developed to resolve this problem.

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Authorizing Statute(s): PL: Pub.L. 109 - 171 120 Name of Law: Deficit Reduction Act of 2005
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0660-AA17	Final or interim final rulemaking	73 FR 54325	09/19/2008

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Application for Digital-to-Analog Converter Box Coupons for Nursing Home Residents	None	Application for Converter Box Coupons for Nursing Home Residents

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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	414,000	0	0	414,000	0	0
Annual Time Burden (Hours)	138,000	0	0	138,000	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: Changing Regulations

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

Burden Reduction Due to:

Short Statement: This is a new collection.

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Annual Cost to Federal Government: $13,000,000

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: 08/29/2008

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