Representations to Implement Appropriations Act Provisions on Felony Convictions and Unpaid Federal Tax Liabilities

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Statement of Determination.docx	Supplementary Document	Uploaded 2012-12-07	Available
Supporting Statement.docx	Supporting Statement A	Uploaded 2013-02-04	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
205053	Representations to Implement Appropriations Act Provisions on Felony Convictions and Unpaid Federal Tax Liabilities	Other-part 1 -- ASD(R&E) memorandum	New

ICR Details

OMB Control No: 0704-0494	ICR Reference No: 201212-0704-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOD/DODDEP	Agency Tracking No:
Title: Representations to Implement Appropriations Act Provisions on Felony Convictions and Unpaid Federal Tax Liabilities
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 12/12/2012
OIRA Conclusion Action: Approved with change	Conclusion Date: 02/06/2013
	Date Received in OIRA: 12/07/2012
Terms of Clearance: This collection is approved for 6 months only based on the revised materials provided by the Department.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2013	6 Months From Approved
Responses	15,000	0	0
Time Burden (Hours)	1,250	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Currently, DoD awarding officials lack information needed to determine prior to awarding a grant or cooperative agreement that the intended recipient is not a corporation with a felony conviction or tax delinquency. The information will be used to remedy that deficiency. It will be collected by stating a requirement in program announcements for applicants to submit representations with their applications.

Emergency Justfication: This emergency submission is necessary and appropriate to ensure that the Department exercises due diligence to preclude making grant and cooperative agreement awards to entities that are made ineligible by the following provisions of the Consolidated Appropriation Act, 2012 (Public Law 112-74): Division A, sections 8124 and 8125; Division B, sections 504 and 505; and Division H, section 514, as well as anticipated follow-on provisions in FY 2013 appropriations.

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Authorizing Statute(s): PL: Pub.L. 112 - 74 8124 Name of Law: null
   PL: Pub.L. 112 - 74 8125 Name of Law: null
   PL: Pub.L. 112 - 74 504 Name of Law: null
   PL: Pub.L. 112 - 74 505 Name of Law: null
   PL: Pub.L. 112 - 74 514 Name of Law: null
  

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

Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Representations to Implement Appropriations Act Provisions on Felony Convictions and Unpaid Federal Tax Liabilities

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ICR Summary of Burden

table that charts list 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	15,000	0	0	15,000	0	0
Annual Time Burden (Hours)	1,250	0	0	1,250	0	0
Annual Cost Burden (Dollars)	0	0	0	0	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: New collection.

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Annual Cost to Federal Government:

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: 12/07/2012

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