Advisory Committee Candidate Biographical Information Request

Forms and Documents

Document Name	Status
Form DOT F 1120.1 Advisory Committee Candidate Biographical Information Request Form	Modified
Supporting Statement - ICR.doc Supporting Statement A	2009-03-31
Privacy Act (P L 93-579).pdf Supplementary Document	2009-03-31
FACA - P L 92-463.pdf Supplementary Document	2009-03-31
30-day FRN.pdf Supplementary Document	2009-03-31
60-day FRNTEXTgate.txt Supplementary Document	2009-03-31

IC Document Collections

IC ID	Document Title	Status
25072	Advisory Committee Candidate Biographical Information Request Form	Modified

ICR Details

OMB Control No: 2105-0009	ICR Reference No: 200903-2105-002
Status: Historical Active	Previous ICR Reference No: 200601-2105-002
Agency/Subagency: DOT/OST	Agency Tracking No: 2105-0009
Title: Advisory Committee Candidate Biographical Information Request
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: 05/28/2009
	Date Received in OIRA: 03/31/2009
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2012	36 Months From Approved	05/31/2009
Responses	100	0	1
Time Burden (Hours)	25	0	25
Cost Burden (Dollars)	0	0	0

---

Abstract: The collection is necessary to gather information from individuals interested in appointments to advisory committees and individuals who have been recommended for membership on an advisory committee to ensure that the committee is balanced and fairly and equitably represents, to the extent feasible, all the various interests that may be affected by the committee’s work and that undue weight not be afforded the views of any one interest, as required by the Federal Advisory Committee Act, P.L. 92-463.

---

Authorizing Statute(s): PL: Pub.L. 93 - 579 Section 2 Name of Law: The Privacy Act of 1974
   PL: Pub.L. 92 - 463 Section 10-12 Name of Law: Federal Advisory Committee Act
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 68491	11/18/2008
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 10645	03/11/2009
Did the Agency receive public comments on this ICR? No

---

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

IC Title	Form No.	Form Name
Advisory Committee Candidate Biographical Information Request	DOT F 1120.1	Advisory Committee Candidate Biographical Information Request

---

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	100	1	0	0	99	0
Annual Time Burden (Hours)	25	25	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:

---

Annual Cost to Federal Government: $0

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)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

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: 03/31/2009

---