Revised Spporting Statement-0970-0265

THE SUPPORTING STATEMENT

The Office of Management and Budget (OMB) requires that for approval under the Paperwork Reduction Act a Supporting Statement must be prepared in the format specified below. Information in the Supporting Statement should be provided in a manner that is responsive to the OMB instructions, and each item must be identified using the numbering system given by OMB. If the Supporting Statement exceeds 10 single-spaced pages in length, there should be a summary not exceeding one page in length which precedes it.

Every effort should be made to keep the Supporting Statement to a length of 10-12 pages. When possible, detailed information should be placed in an attachment, which is then referenced in an appropriate place in the Supporting Statement so that interested reviewers can peruse it. Each attachment should be referenced in the text, so that a reviewer knows why it has been included and which portions may be of particular interest. Brevity and clarity with respect to both the text of the Supporting Statement and any attachments are highly desirable; only the information requested by the OMB outline and needed to understand the project should be included.

This annotated electronic version of the OMB outline for a Supporting Statement has been prepared by the ACF, Office of Planning, Research and Evaluation (OPRE), to assist in the preparation of a request for clearance of an information collection. This template can be downloaded from the PRA E-Office information collection web site.

General Instructions

A Supporting Statement, including the text of the notice to the public required by 5 CFR 1320.5(a)(i)(iv) and its actual or estimated date of publication in the Federal Register, must be entered in worksheet I. The Supporting Statement must be prepared in the format described below, and must contain the information specified in Section A below. If an item is not applicable, provide a brief explanation. OMB reserves the right to require the submission of additional information with respect to any request for approval.

SUPPORTING STATEMENT

FOR THE

ADMINISTRATION FOR NATIVE AMERICANS

Consultant and Evaluator Qualification Form

OMB No. 0970-0265

Reinstatement without change of a previously approved collection for which approval has expired.

1. Justification:

1. Circumstances Making the Collection of Information Necessary:

This information collection is conducted in accordance with 42 USC of the Native American Programs Act of 1972, as amended. Specifically, 42 USC 2991d-1, “Panel review of applications for assistance,” states that ANA will:

(1) “The Commissioner shall establish a formal panel review process for purposes of evaluating applications for financial assistance under sections 2991b and 2991d of this title; and determining the relative merits of the projects for which such assistance is requested.”

(2)“To implement the process established under paragraph (1), the Commissioner shall appoint members of review panels from among individuals who are not officers or employees of the Administration for Native Americans. In making appointments to such panels, the Commissioner shall give preference to American Indians, Native Hawaiians, other Native American Pacific Islanders (including American Samoan Natives), and Alaska Natives.” (See 2991d-1- Panel Review of Applications for Assistance link) Native American Programs Act

The responses to this collection are necessary to allow the Commissioner of ANA to select qualified people to review grant applications for: Social and Economic Development Strategies (SEDS), Native Language Preservation and Maintenance, and Environmental Regulatory Enhancement projects. The panel review process is a legislative mandate in the ANA funding process.

Furthermore, this collection is necessary for the Commissioner to comply with the legislatively required preference given to prospective panel members of American Indians, Native Hawaiians, other Native American Pacific Islanders (including American Samoans), and Alaska Natives.

2. Purpose and Use of the Information Collection:

The purpose of this information collection is to collect information that ANA can use to select qualified people to review grant applications.

The information obtained in this collection allows the Commissioner of ANA to comply with the legislatively required preference under 42 USC 2991d-1, and use that preference in selecting panels members of American Indian, Native Hawaiian, other Native Pacific Islander (including Native Samoan ), and Alaska Native descent (see above link).

3. Use of Improved Information Technology and Burden Reduction:

Applicants/respondents have the option to utilize automated, electronic information technology to complete the Consultant and Evaluator Qualifications Form.

The form is “housed” electronically on the ANA website and the ANA shared drive. The completed forms will be maintained by ANA. Respondents are encouraged to submit the completed forms electronically, but they do have an option to submit in paper form.

4. Efforts to Identify Duplication and Use of Similar Information:

There is no similar information, and ANA program staff has determined through extensive contacts with organizations and individuals in both the private and public sectors that there is no similar data available.

5. Impact on Small Businesses or Other Small Entities:

The collection of this information causes no effect upon small businesses or other small entities. As indicated in paragraph 3 of this document, the information collection tool is designed to enable ANA Commissioner appoint members of review panels from among individuals who are not officers or employees of the Administration for Native Americans. Hence the information being requested and required has been held to the absolute minimum required for the intended use.

6. Consequences of Collecting the Information Less Frequently:

Failure to collect this information would violate the legislative mandate of the Native American Programs Act of 1974 as amended to establish a formal panel review process for purposes of evaluating applications for financial assistance, determining the relative merits of the projects for which such assistance is requested, and in making appointments to such panels, giving preference to American Indians, Native Hawaiians, other Native American Pacific Islanders (including American Samoan Natives), and Alaska Natives.

7. Special Circumstances Relating to the Guidelines of 5 CFR 1320.5.:

There are no special circumstances requiring collection be conducted in any manner described in Item #7 of the OMB Supporting Statement Instructions and Guidance. For example, this data collection instrument does not require respondents to report information to ANA more often than one year or respond to the information request in less than 30 days after receipt of such notice. Prospective applicants may choose to update their information as they deem necessary. In addition, the data collection methodology does not require statistical classifications that have not been approved by OMB.

8. Comments in Response to the Federal Register Notice and Efforts to Consult Outside the Agency:

Federal Register 60-Day Notice, “Proposed Information Collection Activity: Comment Request,” is contained in Volume 79, No. 14, Page 3597, published on January 22, 2014.

In addition to Federal Register Notice, ANA maintains annual consultation with tribal officials throughout the process of developing the data collection tools. ACF/ANA Tribal Consultation Policy supplements the HHS Tribal Consultation Policy and was created in consultation with tribal leaders and a Federal/Tribal Workgroup.

9. Explanation of Any Payment or Gift to Respondents:

No payment or gift to respondents or remuneration to contractors or grantees has been paid.

10. Assurance of Confidentiality Provided to Respondents:

Describe any assurance of confidentiality provided to respondents and the basis for the assurance in stature, regulation, or agency policy.

This information is considered confidential, therefore, safeguards are considered necessary beyond that customarily applied to routine government information. The Consultant and Evaluator Qualifications From is “housed” electronically on the ANA website and is only password accessible by applicants and authorized ANA staff. The completed forms are maintained confidentially by ANA management and designated (authorized) staff. No information of a confidential nature will be disseminated per 45 CFR 73.735-307 (a) Use of official information.

10. Justification for Sensitive Questions:

.

This is not applicable. No information of a sensitive nature is requested in the ANA Consultant and Evaluator Qualifications Form. The information collection request focuses on respondent’s educational qualification and experience to serve as a grant application reviewer.

10. Estimates of Annualized Burden Hours and Costs:

Instrument	Number of Respondents	Number of Responses per Respondent	Average Burden Hour per Response	Total Burden Hours
Consultant and Evaluator Qualifications Form	300	1	1	300

Estimated Total Annual Burden Hours: 300

Public reporting burden for the preparation and review of the ANA funding application is estimated to average 1 hour per response, including the time for reviewing instructions, gathering and maintaining data needed, and reviewing the collection of information.

10. Estimates of Other Total Annual Cost Burden to Respondents and Record Keepers:

The annual cost burden to respondents or record keepers resulting from the collection of information is zero. There are no direct monetary costs to respondents other than their time to complete the form, and the use of existing resources. Respondents are primarily individuals seeking opportunity to be considered as grant application reviewers for specific short period of time. There is no mandatory capital outlay requirement on the part of the government.

10. Annualized Cost to the Federal Government:

The estimated annualized cost to respondents for hour burdens for collection of information identifying and using appropriate wage rate categories is $194.

The form is “housed” electronically on the ANA website, as well as on the shared drive, and will be completed by the applicant. The cost that the Government will incur will be printing the documents when desired and the actual time spent reviewing the forms.

• Costs for printing documents – paper and printer toner = $100

• Costs for tabulating and analysis of responses – 2 hours at $47/hr. = $94

10. Explanation for Program Changes or Adjustments:

There are no program changes or adjustments reported.

10. Plans for Tabulation and Publication and Project Time Schedule:

Data that will be collected will not be tabulated and published. The results of the collection will not be used for any statistical use. The collection of information by means of the ANA Consultant and Evaluator Qualifications Form does not employ statistical methods. The information is used to qualify applications for the purpose of grant panel review. The time schedule for the entire project is 6 months (October-march).

10. Reason(s) Display of OMB Expiration Date is Inappropriate:

This is not applicable. ANA is not asking for approval to not display the expiration date for OMB approval of the information collection.

10. Exceptions to Certification for Paperwork Reduction Act Submissions:

This is not applicable. ANA is not asking for exception to the certification statement as indicated in Item 19, of the “Certification for Paperwork reduction Act Submission”.

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