REQUEST FOR PERSONAL IDENTITY VERIFICATION CARD

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
FIPS-201-1-chng1.pdf	Supplementary Document	Uploaded 2009-06-17	Available
2900-0673 justification revised.docx	Supporting Statement A	Uploaded 2012-08-20	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
44129	REQUEST FOR PERSONAL IDENTITY VERIFICATION CARD	Other-Snap shot	Modified

ICR Details

OMB Control No: 2900-0673	ICR Reference No: 201203-2900-011
Status: Historical Active	Previous ICR Reference No: 200905-2900-001
Agency/Subagency: VA	Agency Tracking No: 2900-0673
Title: REQUEST FOR PERSONAL IDENTITY VERIFICATION CARD
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: 08/27/2012
	Date Received in OIRA: 07/05/2012
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2015	36 Months From Approved	08/31/2012
Responses	100,000	0	100,000
Time Burden (Hours)	8,333	0	8,333
Cost Burden (Dollars)	0	0	0

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Abstract: This collection is necessary to determine VA contractor and affiliate eligibility for Personal Identification Verification (PIV) cards. Sponsors must complete the Sponsor section of the VA PIV Enrollment System Portal to start the PIV Card issuance/re-issuance process and to ultimately issue a PIV Card. It is estimated the average employee will require PIV Card re-issuance every three years. Contractors and affiliates need for PIV Card re-issuance will also depend on the length of the contract or length of service with VA.

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Authorizing Statute(s): None

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 67	04/06/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 124	06/27/2012
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
REQUEST FOR PERSONAL IDENTITY VERIFICATION CARD

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ICR Summary of Burden

table that charts list 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	100,000	100,000	0	0	0	0
Annual Time Burden (Hours)	8,333	8,333	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	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:

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Annual Cost to Federal Government: $239,806

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: 07/05/2012

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