2120-0101 2011

2120-0101 2011.doc

Physiological Training

OMB: 2120-0101

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Supporting Statement for

OMB Control number 2120-0101

Physiological Training

AC FORM 3150‑7




  1. JUSTIFICATION



  1. Explain the circumstances that make the collection of information necessary. Identify any legal or administrative requirements that necessitate the collection.


The collection of information is necessary to determine if the applicants meet the qualifications for training under the FAA/USAF training agreement. The submission of this application information is authorized by the Federal Aviation Reauthorization Act 1996 (Title 49 U.S.C.). In accordance with the USDOT strategic goal: SAFETY, Promote the public health and safety by working toward the elimination of transportation-related deaths and injuries.


  1. Indicate how, by whom, how frequently, and for what purpose the information is to be used.


The information is used by the Aeromedical Education Division (AAM‑400) to determine if the applicant is qualified to receive physiological training. The information received is not designed as "data gathering" as such, because it is obtained as a by‑product from voluntary submission of an application for physiological training. This program is for the benefit of aircrew members. There would be no program without their interest. Frequency is not an issue.


  1. Describe whether, and to what extent, the collection of information involves the use of automated, electronic, mechanical, or other technological collection techniques. Also, describe any consideration of using information technology to reduce burden.


The provisions of the Government Paperwork Elimination Act (GPEA) have been considered for this collection of information. The following procedure is used to collect the data. The information is telephonically provided by the applicant to the training instructor who inputs it into the computer. A hard copy is then sent to the applicant with instructions to sign and return with payment. Currently, electronic signature is not used because a number of applicants do not have the means of electronic transmission.



  1. Describe efforts to identify duplication. Show specifically why any similar information already available cannot be used or modified for use for the purposes described in 2 above.

No duplication exists as AAM‑400 coordinates the training to be conducted at various military and civilian sites. No similar information is available as it is obtained from only air crew members who submit the application in order to receive training.


  1. If the collection of information impacts small businesses or other small entities (item 5 of OMB Form 83‑1), describe any methods used to minimize burden.


There is no involvement of small businesses or other small entities (only involves individuals).


  1. Describe the consequence to Federal program or policy activities if the collection is not conducted or is conducted less frequently, as well as any technical or legal obstacles to reducing burden.


Information submitted is voluntary and frequency is not an issue.


  1. Explain any special circumstances that require the collection to be conducted in a manner inconsistent with the guidelines in 5 CFR 1320.5 (d)(2).


Information submitted by applicants is consistent with subject guidelines in 5 CFR 1320.5 (d) (2).


  1. Provide a copy and identify the date and page number in the Federal Register of the agency's notice. Describe efforts to consult with persons outside the Agency to obtain their views on the availability of date.


A notice was published in the Federal Register on August 27, 2010, vol. 75, no. 166, pages 52803-52804, requesting comments. No comments were received. The collection of this information was coordinated between the FAA and USAF and agreements were reached on all items.


  1. Explain any decision to provide any payment or gift to respondents, other than remuneration of contractors or grantees.


Non‑applicable.


  1. Describe any assurance of confidentiality.


Each applicant is required to sign a "Consent for Release of Application Data and Assumption of Risk." The consent allows any data on AC Form 3150‑7, Application an Agreement for Physiological Training, to be released by the FAA to any Federal agency, department, or military service. ‑The information collected is protected as described in the Privacy Act System of Records DOT/FAA 828, Physiological Training System.


  1. Provide additional justification for any questions of a sensitive nature.


Not applicable to information requested.

  1. Provide estimate of the hour burden of the collection of information. Also, provide estimates of annualized cost to respondents for the hour burdens for the collections of information.


The FAA estimates the total burden per response to be 8 minutes, for an estimated 5,500 airmen that will apply annually.


Annual number of applicants

5,500

Burden per response

8 minutes (.1333 hours)

Total annual burden

733 hours

Total annual cost ($20 per hour for airmen)

$14,660


  1. Provide an estimate of the total annual cost burden to the respondents or record keepers.


There are no additional costs not already included in question twelve.


  1. Provide estimates of annualized cost to the Federal Government.


FAA estimates a total of 4 minutes per response for processing, at $.432 per minute


Estimate of cost to Federal Government:


Printing $258.00

Processing $9,515. 00 (4 min x $.432 per min FG‑13/3 x 5,500 applications)

TOTAL $9,773.00


15. Explain the reasons for any program changes or adjustments reported in Item 13 or 14 of the OMB Form 83‑I.


There are no changes in requirements.


16. For collections of information whose results will be published, outline plans for tabulation and publication.


Not applicable to information requested.


17. If seeking approval to not display the expiration date for OMB approval of the information collection, explain the reasons that display would be inappropriate.


The form used for this collection is printed and stocked for continuous use and is reprinted as stock runs low to avoid any unnecessary delay. It would not be cost affective to destroy dated unused stock, therefore, we are seeking approval to not display the expiration date.


18. Explain each exception to the certification statement identified in item 19, "Certification for Paperwork Reduction Act Submission," of OMB Form 83‑1.


There are no exceptions.

File Typeapplication/msword
File TitleSupporting Statement for
Authortaylor ctr dahl
Last Modified ByTaylor CTR Dahl
File Modified2010-12-02
File Created2010-09-28

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