Combined Federal Campaign

Forms and Documents

Document Name	Status
Form OPM-1647A Combined Federal Campaign Form and Instruction	Unchanged
Form OPM Form 1647-E Family Youth and Support Activities Application Form and Instruction	Unchanged
2012-20384.pdf Supplementary Document	2012-10-22
Justification Statement (8-12).doc Supporting Statement A	2012-08-27
2013 Local Federation Application.DOC Justification for No Material/Nonsubstantive Change	2012-08-27
2013 Local Independent Application.DOC Justification for No Material/Nonsubstantive Change	2012-08-27
2013 National Federation Application.DOC Justification for No Material/Nonsubstantive Change	2012-08-27
2013 National Independent Applicatio.DOC Justification for No Material/Nonsubstantive Change	2012-08-27
2013 FSYA Application.DOC Justification for No Material/Nonsubstantive Change	2012-08-27
2013 National Independent Application - DRAFT[1].DOC Supplementary Document	2012-08-27
2013 National Federation Application - DRAFT[1].DOC Supplementary Document	2012-08-27
2013 Local Independent Application - DRAFT[1].DOC Supplementary Document	2012-08-27
2013 Local Federation Application - DRAFT[1].DOC Supplementary Document	2012-08-27
2013 FSYA Application - DRAFT[1].DOC Supplementary Document	2012-08-27
CFC Application 60-Day FR Notice (May 15, 2012).pdf Supplementary Document	2012-08-27

IC Document Collections

IC ID	Document Title	Status
42892	Combined Federal Campaign Form and Instruction	Unchanged
190418	Family Youth and Support Activities Application Form and Instruction	Unchanged

ICR Details

OMB Control No: 3206-0131	ICR Reference No: 201208-3206-004
Status: Historical Active	Previous ICR Reference No: 201010-3206-009
Agency/Subagency: OPM	Agency Tracking No:
Title: Combined Federal Campaign
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/11/2013
	Date Received in OIRA: 10/22/2012
Terms of Clearance: OMB is tentatively approving this collection with the understanding that it will need to be reevaluated when OPM submits the final version of the regulation.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2016	36 Months From Approved	03/31/2013
Responses	20,000	0	20,000
Time Burden (Hours)	59,600	0	59,600
Cost Burden (Dollars)	4,000	0	4,000

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Abstract: In accordance with E.O. 12353, Public Law 102-393, and 5 CFR Part 950, required information is collected from 501(c)(3) non-profit charitable organizations that apply on an annual basis for participation in the Combined Federal Campaign. The information gathered is reviewed to determine eligibility in the program. OPM has made non-substantive changes to the CFC Applications: CFC National Independent Application (1647-A), CFC National Federation Application (1647-B), CFC Local Independent Application (1647-C), CFC Local Federation Application (1647-D), and CFC FSYA Application (1647-E). The revisions include date changes (e.g. 2012 to 2013), revisions to the instructions based on guidance issued to charities, and the removal of the requirement for an original signature, permitting the program to receive all applications electronically. The changes do not include the addition or removal of any questions, and the burden remains unchanged. The revised forms are included in the Supplementary Document section.

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Authorizing Statute(s): EO: EO 12353 Name/Subject of EO: Combined Federal Campaigns
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
3206-AL05	Final or interim final rulemaking	71 FR 223	11/20/2006

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 28639	05/15/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 50174	08/20/2012
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Combined Federal Campaign	OPM-1647A, OPM 1647C, OPM 1647B, OPM 1647D	National Inernational Independent Organization Application ,   National International Federation Application ,   Local Independent Application ,   Local Federation Application
Family Youth and Support Activities Application	OPM Form 1647-E	2010 CFC FYSA Application

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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	20,000	20,000	0	0	0	0
Annual Time Burden (Hours)	59,600	59,600	0	0	0	0
Annual Cost Burden (Dollars)	4,000	4,000	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: $64,000

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: 10/22/2012

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