83i

PAPERWORK REDUCTION ACT SUBMISSION

Please read the instructions before completing this form. For additional forms or assistance in completing this form, contact your agency's Paperwork
Clearance Officer. Send two copies of this form, the collection instrument to be reviewed, the Supporting Statement, and any additional documentation
to: Office of Information and Regulatory Affairs, Office of Management and Budget, Docket Library, Room 10102, 725 17th Street NW,
Washington, DC 20503.
1. Agency/Subagency originating request

2. OMB control number

b.

None

1110
__ __ __ - __0043
__ __ __
a. __ __

DOJ/FBI
3. Type of information collection (check one)

__ __ __ __

4. Type of review requested (check one)

a.

New Collection

a. ✔ Regular

b.

Revision of a currently approved collection

b.

Emergency - Approval requested by: ____/____/____

c.

Delegated

Extension of a currently approved collection
c.
d. ✔ Reinstatement, without change, of a previously approved

5. Small entities

collection for which approval has expired
Reinstatement, with change, of a previously approved

e.

Will this information collection have a significant economic impact on a
substantial number of small entities?

collection for which approval has expired

Yes

Existing collection in use without an OMB control number

f.

No

✔

6. Requested expiration date

For b-f, note Item A2 of Supporting Statement instructions

a.

✔

Three years from the approval date

b.

_____/_____

7. Title Voluntary Appeal File (VAF) Brochure
8. Agency form number(s) (if applicable)

N/A
9. Keywords

National Instant Criminal Background Check System Voluntary Appeal File
10. Abstract

The Voluntary Appeal File was established to prevent extended delays and erroneous denials pursuant to 28 Code of Federal Regulation, Part 25.9(b)(1),
(2), and (3)
11. Affected public (Mark primary with "P" and all others with "X")

P Individuals or households
a. __

12. Obligation to respond (Mark primary with "P" and all others that apply with "X")

d. __ Farms

Voluntary

a.

b. P Required to obtain or retain benefits
Mandatory
c. __ Not-for-profit institutions
f. __ State, Local, or Tribal Government
c.
14. Annual reporting and recordkeeping cost burden(in thousands of dollars)
13. Annual reporting and recordkeeping hour burden
b. __ Business or other for-profit

e. __ Federal Government

a. Number of respondents
b. Total annual responses

b. Total annual costs (O&M)

1. Percentage of these responses

c. Total annualized cost requested

0

collected electronically
c. Total annual hours requested

%

d. Current OMB inventory
e. Difference

18,855
18,855
0

d. Current OMB inventory
e. Difference

$9,427.50
0
$9,427.50
$135,756
(-$126,328.50)

a. Total annualized capital/startup costs

7,542
7,542

f. Explanation of difference

0
(-$126,328.50)

1. Program change

f. Explanation of difference

2. Adjustment

1. Program change

0
2. Adjustment
15. Purpose of information collection (Mark primary with "P" and all others
that apply with "X")

16. Frequency of recordkeeping or reporting(check all that apply)
a.

a. __ Application for benefits

e. X
__ Program planning or management c.

b. __ Program evaluation

f. __ Research

c. __ General purpose statistics g. P
__ Regulatory or compliance
d. __ Audit

Recordkeeping

b. ✔ Third party disclosure

Reporting:
1.

On occasion

2.

Weekly

4.
7.

Quarterly
Biennially

5.
8.

Semi-annually 6.
Annually
Other (describe) ____________

3.

✔Monthly

18. Agency contact (person who can best answer questions regarding the content

17. Statistical methods
Does this information collection employ statistical methods?
Yes

No ✔

of this submission)

Sherry L. Kuneff, Mgmt./Program Analyst
Name: ______________________________________________________
(304) 625-7462
Phone: ______________________________________________________

OMB 83-I

10/95