Broad Stakeholder Survey (BSHS)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form DHS Form 9041 Office of Emergency Communications Broad Stakeholder Survey	Form and Instruction	New	Repair queued
Supporting Statement A_Broad Stakeholder Survey_v2 lg clean.docx	Supporting Statement A	Uploaded 2013-05-03	Repair queued
PTA, NPPD-BSHS, 20101026, PRIV Final.pdf	Supplementary Document	Uploaded 2013-05-02	Repair queued
Public Law 109-295 (Title XVIII).pdf	Supplementary Document	Uploaded 2013-05-02	Repair queued
30-Day FRN_Broadh Stakeholder Survey_DHS-2012-0042_Published_04-03-2013.pdf	Supplementary Document	Uploaded 2013-05-02	Repair queued
60-Day FRN_Broad Stakeholder Survey_DHS-2012-0042_Published_08-20-2012.pdf	Supplementary Document	Uploaded 2013-05-02	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
206768	Office of Emergency Communications Broad Stakeholder Survey	Form and Instruction	New

ICR Details

OMB Control No:	ICR Reference No: 201305-1670-001
Status: Historical Inactive	Previous ICR Reference No:
Agency/Subagency: DHS/CISA	Agency Tracking No:
Title: Broad Stakeholder Survey (BSHS)
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OIRA Conclusion Action: Withdrawn	Conclusion Date: 01/02/2014
	Date Received in OIRA: 06/25/2013
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		36 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Broad Stakeholder Survey is designed to gather stakeholder feedback on the effectiveness of OEC services and to gather input on challenges and initiatives for interoperable emergency communications.

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Authorizing Statute(s): PL: Pub.L. 109 - 295 1801 Name of Law: Title XVIII - Emergency Communications
  

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 161	08/20/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 64	04/03/2013
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
Office of Emergency Communications Broad Stakeholder Survey	DHS Form 9041	Office of Emergency Communications Broad Stakeholder 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 a new request

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Annual Cost to Federal Government: $67,687

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: 06/25/2013

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