Application for Domestic Indemnification

Forms and Documents

Document Name	Status
Form 3135-0123 Application for Indemnity Form and Instruction	New
DomesticG'lines July 2011 deadline.pdf Supplementary Document	2011-06-27
Supporting Statement 2007.doc Supporting Statement A	2011-05-05

IC Document Collections

IC ID	Document Title	Status
198284	Application for Indemnity Form and Instruction	New

ICR Details

OMB Control No: 3135-0123	ICR Reference No: 201103-3135-005
Status: Historical Active	Previous ICR Reference No: 200805-3135-001
Agency/Subagency: NEA	Agency Tracking No:
Title: Application for Domestic Indemnification
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 with change	Conclusion Date: 07/06/2011
	Date Received in OIRA: 05/18/2011
Terms of Clearance: NEA will be required to submit this collection as a regular information collection rather than a generic clearance when renewing for approval of this collection in three years.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2014	36 Months From Approved	08/31/2011
Responses	50	0	100
Time Burden (Hours)	2,000	0	4,500
Cost Burden (Dollars)	90,000	0	180,000

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Abstract: Applicants for federal indemnity under the Arts and Artifacts Indemnity Act (P.L. 94-158) are required to submit indemnity applications. Respondents include non-profit, tax-exempt organizations (primarily museums).

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Authorizing Statute(s): PL: Pub.L. 94 - 158 1, 89 Stat. 844 Name of Law: Arts and Artifacts Indemnity Act
  

Citations for New Statutory Requirements: PL: Pub.L. 110 - 161 426 Name of Law: Consolidated Appropriations Act of 2008

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
3134-AA01	Final or interim final rulemaking	8 FR 4065	03/04/2008

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	11 FR 1167	01/21/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	11 FR 8629	04/11/2011
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
Application for Indemnity	3135-0123	Application for Indemnity

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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	50	100	0	0	-50	0
Annual Time Burden (Hours)	2,000	4,500	0	0	-2,500	0
Annual Cost Burden (Dollars)	90,000	180,000	0	0	-90,000	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: The number of respondents has been fewer than originally estimated, which reduces the total time burden. The total cost burden has been halved because the staff divides time between the domestic and international indemnity programs. (The international program has a separate ICR.)

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Annual Cost to Federal Government: $90,000

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: 05/18/2011

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