Chronic Hazard Advisory Panel (CHAP) Questionnaire

Forms and Documents

Document Name	Status
Form 0 Chronic Hazard Advisory Panel Questionnaire Form and Instruction	New
OMB_New_CHAP.doc Supporting Statement A	2009-05-20
OMB_New_CHAP_Letter_Questionnaire.pdf Supplementary Document	2009-05-20

IC Document Collections

IC ID	Document Title	Status
189155	Chronic Hazard Advisory Panel Questionnaire Form and Instruction	New

ICR Details

OMB Control No: 3041-0139	ICR Reference No: 200905-3041-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: CPSC	Agency Tracking No:
Title: Chronic Hazard Advisory Panel (CHAP) Questionnaire
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 06/03/2009
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/22/2009
	Date Received in OIRA: 05/20/2009
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2009	6 Months From Approved
Responses	27	0	0
Time Burden (Hours)	27	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The collection of information concerns a questionnaire to panel candidates for selection to a Chronic Hazard Advisory Panel (CHAP) to study the effects of phthalates and phthalate alternatives on children's health.

Emergency Justfication: In order to establish the CHAP and execute the mandatory rulemaking within the statutory deadlines imposed under the CPSIA, the CPSC requests emergency processing of the collection of informaiton under section 3507(j) of the PRA (44 U.S.C. 3507(j) and 5 CFR 1320.13).

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Authorizing Statute(s): PL: Pub.L. 110 - 314 108(b)(2)(A) and (B) Name of Law: Consumer Product Safety Improvement Act
  

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

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
Chronic Hazard Advisory Panel Questionnaire	0	Chronic Hazard Advisory Panel 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	27	0	0	27	0	0
Annual Time Burden (Hours)	27	0	0	27	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 questionnaire would represent a new collection of information and increase the overall information collection burden for the CPSC by 27 hours.

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Annual Cost to Federal Government: $6,562

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

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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: 05/20/2009

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