Tribal Self-Governance Program, 25 CFR 1000

Forms and Documents

Document Name	Status
1000.382 - Annual self-governance report Form	Modified
11-28-12.Renewal IC_Self-Governance Program_30 day.pdf Supplementary Document	2012-11-28
1076-0143 - OSG Program SS.doc Supporting Statement A	2012-11-15
25 CFR 1000.pdf Supplementary Document	2012-11-14
7-24-12.IC_60 day_Self-Governance Program.pdf Supplementary Document	2012-11-14
Tribal Self Governance Act.pdf Supplementary Document	2009-07-28

IC Document Collections

IC ID	Document Title	Status
43770	1000.17 - Admission to applicant pool	Modified
190042	1000.382 - Annual self-governance report Form	Modified
190041	1000.333 - Notice to retrocede	Modified
190040	1000.248 - Notice of proposed changes	Modified
190039	1000.243 - Progress reports and financial status reports	Modified
190038	1000.222 - Request for waiver	Modified
190037	1000.181 - Request to negotiate successor FA	Modified
190036	1000.173 - Request to negotiate a FA	Modified
190035	1000.169, 1000.170 - Letter of interest and supporting documents for FA	Modified
190034	1000.66 - Application for planning and negotiation grant	Modified
190031	1000.50 - Tribal resolution, audits, and proposal for planning phase	Modified
190030	1000.47 - Request for a negotiation grant	Modified
190029	1000.32 - Withdrawal from consortium FA	Modified
190028	1000.19, 20, 21 - Planning report	Modified
190024	1000.18 - Withdrawal from consortium to become member of applicant pool	Modified

ICR Details

OMB Control No: 1076-0143	ICR Reference No: 201206-1076-004
Status: Historical Active	Previous ICR Reference No: 200901-1076-001
Agency/Subagency: DOI/BIA	Agency Tracking No:
Title: Tribal Self-Governance Program, 25 CFR 1000
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 without change	Conclusion Date: 01/29/2013
	Date Received in OIRA: 11/28/2012
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2016	36 Months From Approved	01/31/2013
Responses	94	0	204
Time Burden (Hours)	4,662	0	11,203
Cost Burden (Dollars)	10,500	0	10,500

---

Abstract: This information collection activity and implementing regulations permit the permanent estabishment of tribal self-governance as authorized by the Tribal Self-Governance Act of 1994.

---

Authorizing Statute(s): PL: Pub.L. 103 - 413 402, 403, 405 Name of Law: Title IV - Tribal Self-Governance
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 43353	07/24/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 71016	11/28/2012
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 15

IC Title	Form No.	Form Name
1000.173 - Request to negotiate a FA
1000.19, 20, 21 - Planning report
1000.222 - Request for waiver
1000.17 - Admission to applicant pool
1000.18 - Withdrawal from consortium to become member of applicant pool
1000.32 - Withdrawal from consortium FA
1000.47 - Request for a negotiation grant
1000.66 - Application for planning and negotiation grant
1000.248 - Notice of proposed changes
1000.50 - Tribal resolution, audits, and proposal for planning phase
1000.243 - Progress reports and financial status reports
1000.333 - Notice to retrocede
1000.181 - Request to negotiate successor FA
1000.382 - Annual self-governance report	N/A	Self-Governance Minimum Data Collection
1000.169, 1000.170 - Letter of interest and supporting documents for FA

---

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	94	204	0	0	-110	0
Annual Time Burden (Hours)	4,662	11,203	0	0	-6,541	0
Annual Cost Burden (Dollars)	10,500	10,500	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: Adjustments were made to the number of responses, hour and cost burden to reflect more accurate estimates. In addition, the program uses a form to collect information, which was not included in the last renewal.

---

Annual Cost to Federal Government: $42,575

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

---

Common Form ICR:  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:

(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: 11/28/2012

---