Outreach/Ethnicity Questionnaires

Forms and Documents

Document Name	Status
Form FS-NRS-1700-1 Questionnaires Form	Modified
supporting_statement 0596-0207 2010 7 12 10.doc Supporting Statement A	2010-07-12

IC Document Collections

IC ID	Document Title	Status
180759	Questionnaires Form	Modified

ICR Details

OMB Control No: 0596-0207	ICR Reference No: 201005-0596-004
Status: Historical Active	Previous ICR Reference No: 200706-0596-001
Agency/Subagency: USDA/FS	Agency Tracking No:
Title: Outreach/Ethnicity Questionnaires
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 without change	Conclusion Date: 01/24/2011
	Date Received in OIRA: 11/09/2010
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2014	36 Months From Approved	01/31/2011
Responses	77,500	0	77,500
Time Burden (Hours)	6,458	0	6,458
Cost Burden (Dollars)	0	0	0

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Abstract: This information collection consists of two separate, but related questionnaires. The Northern Research Station (NRS) Outreach Opportunity Questionnaire (FS-NRS-1700-1) is a postcard distributed at university career fairs. The postcard gathers information from students attending the career fair regarding the effectiveness of information provided by NRS on career opportunities in the Forest Service. The second questionnaire collects information from participants participating in FS programs. The Optional Ethnicity Questionnaire (FS-1700-5) collects information from participants in the following Forest Service sponsored programs: Youth Conservation Corps, Volunteer program, Jobs Corps, and other Hosted programs. The information collected is used to prepare the annual Forest Service Senior, Youth, and Volunteer Programs Accomplishment Report.

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Authorizing Statute(s): US Code: 42 USC 1971, 1975a-d, 2000a-2000h-6 Name of Law: Civil Rights Act of 1964
  

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:
	74 FR 30364	06/01/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 68596	11/08/2010
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
Questionnaires	FS-1700-5, FS-NRS-1700-1	NRS Outreach Opportunity Questionnaire ,   Optional Ethnicity 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	77,500	77,500	0	0	0	0
Annual Time Burden (Hours)	6,458	6,458	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:

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Annual Cost to Federal Government: $20,803

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]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

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: 11/09/2010

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