SF 86C

Forms and Documents

Document Name	Status
Form SF 86C SF 86C Form and Instruction	New
SF 86C 60 Day FRN.pdf Supplementary Document	2013-09-30
2013-23835.pdf Supplementary Document	2013-09-30
2013_SF_86C_Supporting_Statement-August_2013.DOC Supporting Statement A	2013-09-30

IC Document Collections

IC ID	Document Title	Status
208856	SF 86C Form and Instruction	New

ICR Details

OMB Control No:	ICR Reference No: 201309-3206-003
Status: Historical Inactive	Previous ICR Reference No:
Agency/Subagency: OPM	Agency Tracking No:
Title: SF 86C
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OIRA Conclusion Action: Withdrawn and continue	Conclusion Date: 12/12/2016
	Date Received in OIRA: 09/30/2013
Terms of Clearance: This collection is withdrawn at the request of the Agency.

	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: This NEW package, unbundled from the SF 86 (OMB 3206-0005) transmits a 30 Day Notice request for clearance for the Federal Register publication notice of a request for review of the SF 86C. The SF 86C is completed by Federal and Non-Federal Employees (including contractors). The sole purpose of completing the SF 86C is to determine if any information on the previously executed SF 86 has changed. The SF 86C is used, in lieu of completing a new SF 86, permitting the individual to indicate that no data changes occurred, on the most recently completed SF 86, and the opportunity to provide new or changed information. Agencies use this form internally and do not use it to request investigations from OPM. This notice will invite comment on the continued need for this form in light of electronic capabilities.

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Authorizing Statute(s): EO: EO 12968 Name/Subject of EO: 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
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 45579	07/29/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 59984	09/30/2013
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
SF 86C	SF 86C	Standard Form 86 Certification

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

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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:  Yes

Description/Changes for Common Form Usage: 

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: 09/30/2013

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