Grant Reviewer Recruitment Form

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 2 non substantive change screen shot	Form and Instruction	Modified	Available
Form 1 DIR Grant Reviewer Recruitment Form	Form	Modified	Available
justification for non sub change.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2014-11-25	Available
Reviewer notice letter.docx	Supplementary Document	Uploaded 2013-11-06	Available
Supporting_Statement.doc	Supporting Statement A	Uploaded 2013-11-06	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
6550	Grant Reviewer Recruitment Form	Form and Instruction	Modified	non substantive change screen shot
6550	Grant Reviewer Recruitment Form	Form	Modified	DIR Grant Reviewer Recruitment Form

ICR Details

OMB Control No: 0915-0295	ICR Reference No: 201411-0915-005
Status: Historical Active	Previous ICR Reference No: 201311-0915-001
Agency/Subagency: HHS/HSA	Agency Tracking No: 20871
Title: Grant Reviewer Recruitment Form
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/11/2014
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/26/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2016	12/31/2016	12/31/2016
Responses	5,250	0	5,250
Time Burden (Hours)	1,707	0	1,707
Cost Burden (Dollars)	0	0	0

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Abstract: This web based grant reviewer form is used to recruit reviewers for HRSA grant and cooperative agreement programs. The form collects reviewer information that is used to select and assign grant reviewers to objective review committees.

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Authorizing Statute(s): US Code: 42 USC 799 Name of Law: Public Health Service Act
  

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 41407	07/10/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 65673	11/01/2013
Did the Agency receive public comments on this ICR? No

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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
Grant Reviewer Recruitment Form	1, 2	DIR Grant Reviewer Recruitment Form ,   non substantive change screen shot

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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	5,250	5,250	0	0	0	0
Annual Time Burden (Hours)	1,707	1,707	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: Approval is requested for a decreased burden level. Original OMB approval for the Grant Reviewer Database form was for a total of 2,750 hours where the new reviewer file creation would take 0.75 hours, and the update 0.5 hours. This current request is for the Reviewer Recruitment Module (RRM) form for 1,707 total burden hours, where a new file creation is 0.33 hours and the file update is 0.16 hours. This is a decrease of 1,043 hours based on the unique simplicity and search power of the RRM system. The 2008 submission anticipated 3,700 reviewers registering in the new database, and we estimate the same number of active reviewers in the future. Now that existing reviewers must annually re-verify or re-register with fresh information, we anticipate a decrease in the estimated number of mid-year file updates (250).

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Annual Cost to Federal Government: $4,250

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: 11/26/2014

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