OSC Forms 11, 12 and 13

Forms and Documents

Document Name	Status
OMB public comment response.docx Supporting Statement A	2014-09-24
OSC.Form.12.pdf Supplementary Document	2014-09-23
osc13.pdf Supplementary Document	2014-09-23
osc11.pdf Supplementary Document	2014-09-23

IC Document Collections

IC ID	Document Title	Status

ICR Details

OMB Control No: 3255-0002	ICR Reference No: 201409-3255-001
Status: Historical Inactive	Previous ICR Reference No: 201206-3255-001
Agency/Subagency: OSC	Agency Tracking No:
Title: OSC Forms 11, 12 and 13
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Improperly submitted	Conclusion Date: 11/07/2014
	Date Received in OIRA: 09/24/2014
Terms of Clearance: This ICR was improperly submitted. It was incorrectly submitted as a generic collection, and there were no forms or a supporting statement submitted. Also, the response to comment document is a mark-up version. Finally, ICR abstracts should provide a summary description of what the collection is.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		36 Months From Approved	02/28/2014
Responses	0	0	2,246
Time Burden (Hours)	0	0	2,689
Cost Burden (Dollars)	0	0	0

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Abstract: This is a request for the renewal of the forms for another 3 year period.

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Authorizing Statute(s): US Code: 5 USC CFR1800 Name of Law: Code of Federal Regulations
  

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:
	79 FR 20247	04/11/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 35579	06/23/2014
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 0

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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: $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? Yes

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: 09/24/2014

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