Uniform Report of DBE Awards/Commitments and other DBE Program Collections

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form DOT Form 4630 Report of DBE Awards and Commitments	Form	Modified	Available
Form Appendix G Personal Net Worth Form	Form and Instruction	New	Repair queued
Form Appendix F Uniform Certification Application Form	Form and Instruction	New	Available
Correction Notice.pdf	Supplementary Document	Uploaded 2014-10-28	Available
30day FRN.pdf	Supplementary Document	Uploaded 2014-10-28	Available
60day FRN.pdf	Supplementary Document	Uploaded 2014-10-28	Available
DBE Final Rule II Supporting Statement 11 13 2014.docx	Supporting Statement A	Uploaded 2014-11-17	Available
Electronic Code of Federal Regulations.mht	Supplementary Document	Uploaded 2010-11-16	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
25080	Report of DBE Awards and Commitments	Form	Modified
213922	Percentages of DBEs in Various Categories		New
213920	Personal Net Worth Form	Form and Instruction	New
213905	Annual Affidavit of No Change		New
213904	Uniform Certification Application Form	Form and Instruction	New

ICR Details

OMB Control No: 2105-0510	ICR Reference No: 201410-2105-001
Status: Historical Active	Previous ICR Reference No: 201209-2105-004
Agency/Subagency: DOT/OST	Agency Tracking No:
Title: Uniform Report of DBE Awards/Commitments and other DBE Program Collections
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/05/2015
	Date Received in OIRA: 11/17/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2018	36 Months From Approved
Responses	50,852	0	0
Time Burden (Hours)	149,161	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This is to request the Office of Management and Budget (OMB) to provide Paperwork Reduction Act (PRA) clearance on five information collections associated with the Department's Disadvantaged Business Enterprise (DBE) program, four of which were included in the Notice of Proposed Rulemaking (NPRM), entitled "Disadvantaged Business Enterprise: Program Implementation Modifications," published on September 6, 2012. See 77 FR 54952. The Department published a correction to this NPRM on October 25, 2012, that included the fifth collection and extended the comment period for 60 days until December 24, 2012. See 77 FR 65164. As announced in a Federal Register notice published on November 13, 2013, the Department subsequently reopened the comment period until December 26, 2013, and held a public meeting on December 5, 2013. See 78 FR 68016. The Department published a Final Rule on October 2, 2014 that finalized, with modifications, the proposed changes in the NPRM, including those related to the Paperwork Reduction Act. 79 FR 59566. The Department seeks to combine all five collections into one OMB Control Number because it believes this will lead to more efficient administration on the part of DOT.

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Authorizing Statute(s): US Code: 49 USC 47113 Name of Law: null
  

Citations for New Statutory Requirements: US Code: 49 USC 47113 Name of Law: null

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
2105-AE08	Final or interim final rulemaking	79 FR 59566	10/02/2014

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

table that charts list of burden

IC Title	Form No.	Form Name
Percentages of DBEs in Various Categories
Personal Net Worth Form	Appendix G	Personal Net Worth Statement
Uniform Certification Application Form	Appendix F	Certification Application For Internal Coordination
Report of DBE Awards and Commitments	DOT Form 4630	Uniform Report of DBE Awards/Commitments and Payments
Annual Affidavit of No Change

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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	50,852	0	0	49,052	0	1,800
Annual Time Burden (Hours)	149,161	0	0	140,161	0	9,000
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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: As part of this rulemaking, the Department is requesting the four other collections that currently have no control number now be included under 2105-0510 and that OMB grant approval of them for three years. These collections are: Uniform Certification Application Form, Annual Affidavit of No Change, DOT Personal Net Worth Form, and Reporting Requirement for Percentages of DBEs in Various Categories. The Department seeks to combine all five collections into one OMB Control Number because it believes this will lead to more efficient administration on the part of DOT.

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Annual Cost to Federal Government: $88,287

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: 11/17/2014

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