Financial Status Reporting Form for Program of State Council on Developmental Disabilities

Forms and Documents

Document Name	Status
Form 0985-0026 Financial Status Reporting Form for Program of State Council on Developmental Disabilities Form and Instruction	Modified
0985-0026 Supporting Statement.docx Supporting Statement A	2012-07-25

IC Document Collections

IC ID	Document Title	Status
10206	Financial Status Reporting Form for Program of State Council on Developmental Disabilities Form and Instruction	Modified

ICR Details

OMB Control No: 0985-0026	ICR Reference No: 201208-0985-001
Status: Historical Active	Previous ICR Reference No: 201205-0985-003
Agency/Subagency: HHS/ACL	Agency Tracking No:
Title: Financial Status Reporting Form for Program of State Council on Developmental Disabilities
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: 11/07/2012
	Date Received in OIRA: 08/01/2012
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2015	36 Months From Approved	11/30/2012
Responses	165	0	165
Time Burden (Hours)	842	0	842
Cost Burden (Dollars)	0	0	0

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Abstract: For the program of the State Council on Developmental Disabilities, funds are awarded to Stage Agencies contigent on fiscal requirements in Subtitle B of the Developmental Disabilities Assistance and Bill of Rights Act.

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Authorizing Statute(s): PL: Pub.L. 106 - 402 Subtitle B Name of Law: DDA Bill of Rights Act of 2000
  

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 240	12/14/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 142	07/24/2012
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
Financial Status Reporting Form for Program of State Council on Developmental Disabilities	0985-0026	Financial Status Report State Councils on Dev. Disabilities

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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	165	165	0	0	0	0
Annual Time Burden (Hours)	842	842	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: $3,300

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: 08/01/2012

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