Office of Investment Policy Questionnaire

Forms and Documents

Document Name	Status
Form OPIC-248 Office of Investment Policy Questionnaire Form	Modified
OPIC Form 248 - Justificiation Statement.pdf Supporting Statement A	2012-08-10

IC Document Collections

IC ID	Document Title	Status
202810	Office of Investment Policy Questionnaire Form	Modified

ICR Details

OMB Control No: 3420-0032	ICR Reference No: 201208-3420-001
Status: Historical Active	Previous ICR Reference No: 201206-3420-007
Agency/Subagency: OPIC	Agency Tracking No: OPIC-248
Title: Office of Investment Policy Questionnaire
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  Yes
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/27/2012
	Date Received in OIRA: 08/10/2012
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2015	36 Months From Approved
Responses	230	0	0
Time Burden (Hours)	1,012	0	0
Cost Burden (Dollars)	64,589	0	0

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Abstract: This application is sent to U. S. companies requesting financing or political risk insurance from OPIC. The information requested is required to determine the expected effects of proposed projects on the U. S. economy and employment, as well as the effects on the environment, economic development, and worker rights abroad.

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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:
	76 FR 231	12/01/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 18	01/27/2012
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Office of Investment Policy Questionnaire	OPIC-248	Office of Investment Questionnaire

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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	230	0	0	230	0	0
Annual Time Burden (Hours)	1,012	0	0	1,012	0	0
Annual Cost Burden (Dollars)	64,589	0	0	64,589	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new collection,this form 248 has been separated from the Finance Application 115 in order to save time for investors.

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Annual Cost to Federal Government: $23,187

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? Yes

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:  Yes

Description/Changes for Common Form Usage:  This information collected enables OPIC to comply with its congressional mandate to manage the program in a prudent manner and to ensure that projects with significant adverse effects on the U. S. economy and employment do not receive OPIC support. This form was created to increase efficiencies.

Approved RCFs using this ICR

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title

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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: 08/10/2012

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