Supporting Statement Supplemental Form Title III

Supporting Statement Supplemental Form Title III.doc

Supplemental Form to the Financial Status Report for all AoA Title III Grantees

OMB: 0985-0004

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Supporting Statement PART A

0985-004 Supplemental Form to the Financial Status Report for all AoA Title III Grantees

A. Justification

  1. Circumstances Making the Collection of Information Necessary


The Administration on Aging requires grantees funded under the Older American Act, P.L. 106-501, to report semi-annually on the financial status report of the performance of their projects. The specifications for reporting are consistent with 45 CFR 92.40 (b)(1). The financial report is submitted on standard form OMB 269. This clearance requests an extension of the currently approved Supplemental collection form.


  1. Purpose and Use of the Information Collection


The information submitted by State Agencies will be used by AoA to respond to statutory requirements relative to expenditures of Title III program funds, to effectively monitor use of funds, and to respond to Congress, OMB, GAO and others.


  1. Use of Improved Technology and Burden Reduction


The information may be submitted in electronic format.


  1. Efforts to Identify Duplication and Use of Similar Information


No other data source collects similar information.


  1. Impact on Small Business or Other Small Entities


This Information does not involve small businesses. It is collected from the 56 Title III State Agencies on Aging and the Supplemental Form is typically limited to two pages.


  1. Consequences of Collecting the Information Less Frequently


The Financial Status Report is a semi-annual report. If the reports were not to be made less frequently, opportunities to monitor and provide needed guidance would not be available to grantees.


  1. Special Circumstances Relating to the Guidelines of 5 CFR 1320.5


There are no special circumstances requiring explanation


  1. Comments in Response to the Federal Register Notice and Efforts to Consult Outside the Agency


AoA received no comments to the Federal Register Notice Published July 21, 2010: http://www.gpo.gov/fdsys/pkg/FR-2010-07-21/pdf/2010-17822.pdf


  1. Explanation of Any Payment or Gift to Respondents


No payment provided


  1. Assurance of Confidentiality Provided to Respondents


Data in the Financial Status Reports are not confidential. It is financial and program data concerning the use of Federal funds.


  1. Justification for Sensitive Questions


There are no questions of a sensitive nature required.


  1. Estimates of Annualized Burden Hours and Costs


    1. Estimated number of Respondents……………………………………………… 56

    2. Frequency of Response……………………………………………...twice per year

    3. Estimated Annual Hour Burden (56 times 2) ……………………………112 hours


  1. Estimates of Other Total Annual Cost Burden to Respondents and Record Keepers

There are no additional costs to the respondents other than their time.


  1. Annualized Costs to the Federal Government

Hours Used in Calculation:

    1. Preparing AoA Supplemental Form, and instructions,

and request of OMB review:………………………………………………40 hours

    1. Disseminating reporting instructions and Supplemental

Form to the network……………………………………………………….. 8 hours

    1. Regional Office Review of Supplemental Form from each

State (1/2 hour for each of the 56 State Agencies)

is 28 x 2 per year…………………………………………………………..56 hours

    1. Central office analysis and computerization of

information submitted .……………………………………………………40 hours

Total Government Hours…………144 hours

Government Salary for Corresponding 144 hours:

    1. DC Salary Table 2010 GS-13-1 has a

yearly rate of $89,033 and an hourly rate of

$42.66 per hour. Estimated 84 hours……………………………………….$3,583

    1. DC Salary Table 2010 GS-12-1 has a

yearly rate of $77,872 and an hourly rate of

$35.88 per hour. Estimated 56 hours……………………………………….$2,009

    1. DC Salary Table 2010 GS-7-1 has a

yearly rate of $42,209 and an hourly rate of

$20.22 per hour. Estimated 4 hours…………………………………………...$81

Total Costs to Government…………$5,674


  1. Explanation for Program Changes or Adjustments


There have been no changes in burden hours.


  1. Plans for Tabulation and Publication and Project Time Schedule


AoA normally issues a press release on newly funded projects. In addition, a Compendium of Active Grants is posted on http://www.aoa.gov/AoaRoot/grants/Compendium/index.aspx each year.


  1. Reason(s) Display of OMB Expiration Date is Inappropriate


The Administration of Aging will display the expiration date on the Supplemental Form to the Financial Status Report.


  1. Exceptions to Certification for paperwork Reduction Act Submissions


There are no exceptions to the certification state.



B. Statistical Methods (used for collection of information employing statistical methods)


These collections do not employ statistical methods



File Typeapplication/msword
File TitleBilling Code 4154-01
AuthorDHHS
Last Modified ByELong
File Modified2010-10-29
File Created2010-10-12

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