Civil Rights Title VI - Collection Reports - FNS-191 and FNS-101

Forms and Documents

Document Name	Status
Form FNS 101 Screenshot Civil Rights Title VI - Collection Reports - FNS-191 and FNS-101 Form and Instruction	Modified
Federal Cost Estimate Table.pdf Supplementary Document	2012-05-16
Supporting Statement - OMB 0584-0025 REV 5 24 12v2.docx Supporting Statement A	2012-05-25

IC Document Collections

IC ID	Document Title	Status
2909	Civil Rights Title VI - Collection Reports - FNS-191 and FNS-101 Form and Instruction	Modified

ICR Details

OMB Control No: 0584-0025	ICR Reference No: 201201-0584-014
Status: Historical Active	Previous ICR Reference No: 200812-0584-001
Agency/Subagency: USDA/FNS	Agency Tracking No:
Title: Civil Rights Title VI - Collection Reports - FNS-191 and FNS-101
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/27/2012
	Date Received in OIRA: 05/25/2012
Terms of Clearance: Permission not to display the OMB control number is not granted for this collection. The OMB control number along with the expiration date must be displayed on the approved forms.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2015	36 Months From Approved	08/31/2012
Responses	2,927	0	2,863
Time Burden (Hours)	5,854	0	5,726
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of this collections is to track and monitor racial/ethnic data for program evaluation and compliance with the Civil Rights Act.

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Authorizing Statute(s): US Code: 42 USC 2000d-2000d-7 Name of Law: Title VI Civil Rights Act, 1964
  

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:
	77 FR 6775	02/09/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 102	05/25/2012
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
Civil Rights Title VI - Collection Reports - FNS-191 and FNS-101	FNS-101_page1_part2 Screenshot, FNS-101_page2 Screenshot, FNS 191, FNS-191, FNS-101, FNS 101 Screenshot	Participation in Food Program By Race E-form ,   Participation in Food Program By Race E-form ,   Participation in Food Program By Race E-form ,   RACIAL/ETHNIC GROUP PARTICIPATION COMMODITY SUPPLEMENTAL FOOD PROGRAM Screenshot ,   Racial/Ethic Group Participation Commodity Supplemental Food Program ,   Participation in Food Programs - By Race

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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	2,927	2,863	0	0	64	0
Annual Time Burden (Hours)	5,854	5,726	0	0	128	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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 revision a currently approved collection. The proposed burden of 5,854 hours for FY 2012 is an increase of 128 hours from the current burden of 5,726 hours. The adjustment is due to an increase in the number of respondents from 2,863 to 2,927 that will complete a report.

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Annual Cost to Federal Government: $114,035

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: 05/25/2012

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