USCG Academy Application and Supplemental Forms

Forms and Documents

Document Name	Status
Form CGA-14, CGA-14A, C USCG Academy Application and Supplemental Forms Form	Modified
1625-0004 Supporting Statement (8.29.12).doc Supporting Statement A	2012-08-30
30 Day Federal Register.doc Supplementary Document	2011-12-21
2016 PFE Manual.pdf Supplementary Document	2011-12-21
2016 Applicant Handbook.pdf Supplementary Document	2011-12-21
Recruiting Files System of Records Notice - 027.pdf Supplementary Document	2011-12-07
Military Pay and Personnel System of Records Notice - 014.pdf Supplementary Document	2011-12-07
1625-0004 33 CFR 40.1.pdf Supplementary Document	2011-12-07
1625-0004 14 USC 181+182.pdf Supplementary Document	2011-12-07
1625-0004 NOCrev1.doc Supplementary Document	2011-12-21
privacy_pia_uscg_acadis.pdf Supplementary Document	2011-12-07
60 Day Federal Register.doc Supplementary Document	2011-12-07

IC Document Collections

IC ID	Document Title	Status
20447	USCG Academy Application and Supplemental Forms Form	Modified

ICR Details

OMB Control No: 1625-0004	ICR Reference No: 201205-1625-008
Status: Historical Active	Previous ICR Reference No: 201109-1625-001
Agency/Subagency: DHS/USCG	Agency Tracking No:
Title: USCG Academy Application and Supplemental Forms
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 08/30/2012
	Date Received in OIRA: 05/22/2012
Terms of Clearance: Pursuant to 5 CFR 1320 and the Paperwork Reduction Act, OMB approves this collection for three years. OMB notes that an agency should not collect information based on a revision to a collection until the agency has received OMB approval.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2015	36 Months From Approved	08/31/2012
Responses	4,500	0	4,000
Time Burden (Hours)	24,250	0	8,100
Cost Burden (Dollars)	2,500	0	0

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Abstract: This collection contains the application and all supplemental forms required to be considered as an applicant to the United States Coast Guard Academy. Additional information may be requested, but no new or pre-existing OMB forms are used.

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Authorizing Statute(s): US Code: 14 USC 211 Name of Law: Original appointment of permanent commissioned officers
  

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:
	76 FR 62426	10/07/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 78286	12/16/2011
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
USCG Academy Application and Supplemental Forms	CGA-14, CGA-14A, CGA-14B, CGA-14C, CGA-14D	Coast Guard Academy Forms

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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	4,500	4,000	0	0	500	0
Annual Time Burden (Hours)	24,250	8,100	0	0	16,150	0
Annual Cost Burden (Dollars)	2,500	0	0	0	2,500	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: There is no change to the information being collected from respondents. The use of e-forms, which the respondents are not required to print or return via mail to the USCGA, is a change which has decreased the total annual cost burden to respondents and record keepers. The estimate of annualized cost to the Federal Government has increased since the previously reported estimate did not include the time for USCGA faculty/staff members to review submitted data. While the use of e-forms has not reduced the hour burden for respondents completing the EIE, MIE, or PE forms, the estimate of the hour burden for respondents completing the OA has increased since the previously reported estimate did not include the time required to complete four personal statements. In addition, the estimate of the hour burden for completion of the PFE has increased since the previously reported estimate only included the student and not the teacher's time. Overall, this collection of forms is easier for the respondents to complete and record keepers to process compared to the previous collection due to the technology employed within the e-forms.

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Annual Cost to Federal Government: $136,560

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: 05/22/2012

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