E-Appeal/US Merit Systems Protection Board Appeal Form

ICR 201210-3124-002

OMB: 3124-0009

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supporting Statement A
2012-10-31
Supplementary Document
2012-10-26
Supplementary Document
2012-10-26
IC Document Collections
IC ID
Document
Title
Status
32657 Modified
ICR Details
3124-0009 201210-3124-002
Historical Active 201108-3124-001
MSPB
E-Appeal/US Merit Systems Protection Board Appeal Form
Reinstatement without change of a previously approved collection   No
Emergency 11/27/2012
Approved without change 11/26/2012
Retrieve Notice of Action (NOA) 11/19/2012
  Inventory as of this Action Requested Previously Approved
05/31/2013 6 Months From Approved
7,150 0 0
7,150 0 0
0 0 0

This is a voluntary form completed by persons who file appeals with the U.S. Merit Systems Protection Board. The form serves as a guide to appellants in providing all needed information. It is available both as a static form, which is available upon request, on our website (http://www.mspb.gov/appeals/forms.htm), and as an online interactive application (https://e-appeal.mspb.gov).
See attachment letter from MSPB to the Administrator, OIRA.

US Code: 5 USC 1204, 1221, 3330a, 7701 Name of Law: Civil Service Reform Act and others
  
None

Not associated with rulemaking

No

1
IC Title Form No. Form Name
E-Appeal/US Merit Systems Protection Board Appeal Form 185 MSPB E-Appeal Form

  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 7,150 0 0 0 0 7,150
Annual Time Burden (Hours) 7,150 0 0 0 0 7,150
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$27,390
No
No
No
No
No
Uncollected
Darryl Aaron 202 254-4474 [email protected]

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
10/31/2012


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