Application of the Employee Polygraph Protection Act

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form WH-1481 Notice to Examinee Applicable to Certain Ongoing Investigations, Security Services, and Security of Controlled Substances	Form	Modified	Available
news rel ocwage Table 1.pdf	Supplementary Document	Uploaded 2014-05-30	Available
empsit_01102014 Table B8.pdf	Supplementary Document	Uploaded 2014-05-30	Available
1235-0005 60dayFR notice 20140401.pdf	Supplementary Document	Uploaded 2014-05-30	Available
1235-0005ss(20140602).doc	Supporting Statement A	Uploaded 2014-06-05	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
198519	Test Results Written Report and Test Record Maintenance--Employer		Modified
185481	Test Results Written Report and Test Record Maintenance--Polygrapher		Unchanged
185480	Notice of Test Results		Modified
185476	Notice to Polygraph Examiner Identifying Persons to be Examined		Modified
185475	Notice to Examinee--Ongoing Investigations of Employer's Economic Loss or Injury		Modified
13874	Notice to Examinee Applicable to Certain Ongoing Investigations, Security Services, and Security of Controlled Substances	Form	Modified

ICR Details

OMB Control No: 1235-0005	ICR Reference No: 201402-1235-002
Status: Historical Active	Previous ICR Reference No: 201102-1235-001
Agency/Subagency: DOL/WHD	Agency Tracking No:
Title: Application of the Employee Polygraph Protection Act
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 without change	Conclusion Date: 10/30/2014
	Date Received in OIRA: 09/26/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2017	36 Months From Approved	10/31/2014
Responses	757,400	0	757,400
Time Burden (Hours)	68,739	0	68,739
Cost Burden (Dollars)	0	0	0

---

Abstract: These third-party notifications and recordkeeping requirements help ensure polygraph examinees receive the protections and rights provided by the Employee Polygraph Protection Act (EPPA).

---

Authorizing Statute(s): US Code: 29 USC 2001, et seq. Name of Law: The Employee Polygraph Protection Act of 1988
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 18319	04/01/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 57981	09/26/2014
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 6

table that charts list of burden

IC Title	Form No.	Form Name
Notice to Examinee Applicable to Certain Ongoing Investigations, Security Services, and Security of Controlled Substances	WH-1481	Notice to Examinee-Employee Polygraph Protection Act
Notice of Test Results
Notice to Examinee--Ongoing Investigations of Employer's Economic Loss or Injury
Test Results Written Report and Test Record Maintenance--Polygrapher
Notice to Polygraph Examiner Identifying Persons to be Examined
Test Results Written Report and Test Record Maintenance--Employer

---

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	757,400	757,400	0	0	0	0
Annual Time Burden (Hours)	68,739	68,739	0	0	0	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:

---

Annual Cost to Federal Government: $90,200

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

---

Common Form ICR:  No

---

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: 09/26/2014

---