Required Data Elements for Paternity Establishment Affidavits

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
2014_OCSE_0009_Required_Data_Elements_Supporting_Statement_Final_Clean.docx	Supporting Statement A	Uploaded 2014-05-09	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
9965	Required Data Elements for Paternity Establishment Affidavits		Modified

ICR Details

OMB Control No: 0970-0171	ICR Reference No: 201401-0970-005
Status: Historical Active	Previous ICR Reference No: 201104-0970-003
Agency/Subagency: HHS/ACF	Agency Tracking No: 21367
Title: Required Data Elements for Paternity Establishment Affidavits
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 05/16/2014
	Date Received in OIRA: 01/29/2014
Terms of Clearance: ACF had used a consensus-based approach, with stakeholder input, when developing the original list of required items. In response to the FR notice for this ICR, ACF received comments from some of these stakeholders, indicating that their program needs might be better met if (1) several items that are currently optional become “required” for all states, and (2) ACF makes it a requirement that certain clarifications be included in state forms so that (a) the signatories fully understand what they are signing, what the affidavit process involves, what their rights are, and (b) there is consistency across states as to when paternity is really established in the affidavit process. ACF will use a similar consensus-based approach to consider these recommendations more formally and systematically for the next ICR associated with paternity establishment affidavits.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2017	36 Months From Approved	06/30/2014
Responses	1,113,719	0	1,167,097
Time Burden (Hours)	189,332	0	198,406
Cost Burden (Dollars)	0	0	0

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Abstract: Sections of the Social Security Act require the Secretary of Health and Human Services to specify the minimum requirements of an affidavit to be used for the voluntary establishment of paternity. The Act also requires States to enact laws requiring the development and the use of an affidavit for the voluntary acknowledgement of paternity which includes the minimum requirements of the affidavit specified by the Secretary. The information collected will be used by State birth record agencies and State IV-D offices, if needed, in child support enforcement activities.

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Authorizing Statute(s): US Code: 42 USC 666 Name of Law: Child Support
  

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 48171	08/07/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 3597	01/22/2014
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
Required Data Elements for Paternity Establishment Affidavits

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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	1,113,719	1,167,097	0	0	-53,378	0
Annual Time Burden (Hours)	189,332	198,406	0	0	-9,074	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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: There were no program changes, however, there were a decrease in the number of unwed fathers that established paternity.

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Annual Cost to Federal Government: $0

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: 01/29/2014

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