Application for Senior Administrative Law Judge & Geographic Preference Statement for Senior Administrative Law Judge

ICR 201108-3206-001

OMB: 3206-0248

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Form and Instruction
Modified
Supplementary Document
2011-08-16
Supporting Statement A
2011-08-15
Supplementary Document
2011-08-15
ICR Details
3206-0248 201108-3206-001
Historical Active 201101-3206-001
OPM
Application for Senior Administrative Law Judge & Geographic Preference Statement for Senior Administrative Law Judge
Revision of a currently approved collection   No
Regular
Approved without change 10/07/2011
Retrieve Notice of Action (NOA) 08/16/2011
  Inventory as of this Action Requested Previously Approved
10/31/2014 36 Months From Approved 10/31/2011
250 0 350
138 0 163
0 0 0

OPM 1655 and OPM 1655A will be used by retired Administrative Law Judges seeking reemployment to complete hearings in accordance with the Administrative Procedures Act of 1946. These forms will streamline the application process by providing all needed information on 2 forms. The forms are not changing however the burden has decreased due to a decreased respondent pool.

US Code: 5 USC 3323(b) Name of Law: null
  
None

Not associated with rulemaking

  76 FR 25379 05/04/2011
76 FR 50769 08/16/2011
No

  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 250 350 0 -100 0 0
Annual Time Burden (Hours) 138 163 0 -25 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
respondent pool has decreased from previous estimates and submissions.

$59,219
No
No
No
No
No
Uncollected
Miles Windsor 202 606-8358 [email protected]

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
08/16/2011


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