Brain Power

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form J Teachers (online)	Form and Instruction	New	Repair queued
Form P Teachers	Form and Instruction	New	Repair queued
Form T Parents survey (k-5)	Form and Instruction	New	Repair queued
Form S Parents postcard (6-9)	Form and Instruction	New	Repair queued
Form S Parents postcard (k-5)	Form and Instruction	New	Repair queued
Form T Parents Survey (6-9)	Form and Instruction	New	Repair queued
Form G Students (6-9)	Form and Instruction	New	Repair queued
Form A Students (k-5)	Form and Instruction	New	Repair queued
Danya Request for OMB Extension (0925-0542) Section B REVISED June 10 2010 (2) (2).docx	Supporting Statement B	Uploaded 2010-09-30	Repair queued
Danya Request for OMB Extension (0925-0542) Section A - REVISED June 10 2010 (8).docx	Supporting Statement A	Uploaded 2010-10-04	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
195209	Teachers (online)	Form and Instruction	New
195208	Teachers	Form and Instruction	New
195207	Parents survey (k-5)	Form and Instruction	New
195206	Parents postcard (6-9)	Form and Instruction	New
195205	Parents postcard (k-5)	Form and Instruction	New
195204	Parents Survey (6-9)	Form and Instruction	New
195203	Students (6-9)	Form and Instruction	New
195202	Students (k-5)	Form and Instruction	New

ICR Details

OMB Control No:	ICR Reference No: 201011-0925-004
Status: Historical Inactive	Previous ICR Reference No:
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: Brain Power
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: Improperly submitted	Conclusion Date: 01/10/2011
	Date Received in OIRA: 11/09/2010
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		12/31/2011
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The primary goals of the Brain Power! curricula include the following are: o Increasing students' knowledge about the biology of the brain and the neurobiology of drug addiction o Increasing positive attitudes toward science, careers in science, and science as an enjoyable endeavor, and stimulating interest in scientific careers o Promoting more balanced perceptions and attitudes of scientists as being of many races, ages, and genders The secondary goal is to determine the influence or change of attitudes toward and intentions about drug use.

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Authorizing Statute(s): US Code: 42 USC 285o Name of Law: NIDA
  

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:
	75 FR 36659	06/24/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 60128	09/29/2010
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 8

table that charts list of burden

IC Title	Form No.	Form Name
Students (6-9)	G	6-9
Students (k-5)	A, B, C, D, E, F	k-1 ,   k-1 attitudes ,   2-3 ,   2-3 ,   4-5 ,   4-5
Parents Survey (6-9)	T	2-8
Parents postcard (k-5)	S	postcard
Parents survey (k-5)	T	2-8
Teachers	P	k-8
Teachers (online)	L, K, J, I, H, M, N, O	2-3 ,   k-1 ,   k-1 ,   4-5 ,   6-9 ,   6-9 ,   4-5 ,   2-3
Parents postcard (6-9)	S	postcard 6-9

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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: This is a new collection of information.

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Annual Cost to Federal Government: $253,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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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