Gilman Evaluation Survey

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form SV-2012-0008 Gilman Evaluation Survey	Form and Instruction	New	Repair queued
Gilman Supporting Statement PART B (3-2013)docx.docx	Supporting Statement B	Uploaded 2013-03-13	Repair queued
Legal Authorities (3-2013).doc	Supplementary Document	Uploaded 2013-03-13	Repair queued
Gilman Supporting Statement (3-2013)docx.docx	Supporting Statement A	Uploaded 2013-03-13	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
206118	Gilman Evaluation Survey	Form and Instruction	New

ICR Details

OMB Control No:	ICR Reference No: 201303-1405-002
Status: Historical Inactive	Previous ICR Reference No:
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Gilman Evaluation Survey
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn	Conclusion Date: 05/02/2013
	Date Received in OIRA: 03/13/2013
Terms of Clearance: State Department may resubmit when it has completed additional analysis supporting the collection of information.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		12 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This new information collection will allow ECA/P/V to conduct a survey to review the experiences of Gilman Scholarship grant recipients while abroad; probe ways in which they shared what they learned with family, peers, and other community members upon returning to the U.S.; and investigate whether the international experience factored into their subsequent educational and professional choices. The survey will be sent to all grant recipients who studied abroad over a 9-yr period, and entirely web-based.

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Authorizing Statute(s): US Code: 22 USC 2451 et seq Name of Law: • Mutual Educational and Cultural Exchange Act of 1961, as amended
  

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:
	77 FR 75251	12/19/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 15801	03/12/2013
Did the Agency receive public comments on this ICR? Yes

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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
Gilman Evaluation Survey	SV-2012-0008	Gilman Evaluation Survey

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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

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Annual Cost to Federal Government: $192,033

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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: 03/13/2013

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