NPS Institutional Animal Care and Use Committee (IACUC) General Submission, Exhibitor, Annual Review, and Amendment Forms

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 10-1303 IACUC Concurrence Form	Form	New	Available
Form 10-1303 IACUC Concurrence Form	Form	New	Available
Form 10-1304 IACUC BioBlirz Study Form	Form	New	Repair queued
Form 10-1304 IACUC BioBlitz Field Study Form	Form	New	Available
Form 10-1302 IACUC Annual Review Form	Form	Modified	Available
Form 10-1302 IACUC Annual Review Form	Form	Modified	Available
Form 10-1301A IACUC Amendment Form	Form	Modified	Available
Form 10-1301A IACUC Amendment Form	Form	Modified	Available
IACUC Exhibitor Submission Form	Form and Instruction	Removed	Available
IACUC Exhibitor Submission Form	Form and Instruction	Removed	Available
Form 10-1301 IACUC General Submission Form	Form	Modified	Available
Form 10-1301 IACUC General Submission Form	Form	Modified	Available
1024-0265 30 Day FRN.pdf	Supplementary Document	Uploaded 2016-03-30	Available
1024-0265 60 Day FRN.pdf	Supplementary Document	Uploaded 2016-03-22	Available
IACUC Supporting_Statement_A _3-24.2016.doc	Supporting Statement A	Uploaded 2016-03-24	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
220710	IACUC Concurrence Form (private)	Form	New	IACUC Concurrence Form
220709	IACUC Concurrence Form (state and local)	Form	New	IACUC Concurrence Form
220708	IACUC Field Study/BioBlitz Form (private)	Form	New	IACUC BioBlirz Study Form
220707	IACUC Field Study/BioBlitz Form (State and Local)	Form	New	IACUC BioBlitz Field Study Form
205460	IACUC Annual Review Form (private)	Form	Modified	IACUC Annual Review Form
205459	IACUC Annual Review Form (state and local)	Form	Modified	IACUC Annual Review Form
205458	IACUC Amendment Form (private)	Form	Modified	IACUC Amendment Form
205456	IACUC Amendment Form (state and local)	Form	Modified	IACUC Amendment Form
205455	IACUC Exhibitor Submission Form (private)	Form and Instruction	Removed	IACUC Exhibitor Submission Form
205453	IACUC Exhibitor Submission Form (state and local)	Form and Instruction	Removed	IACUC Exhibitor Submission Form
205407	IACUC General Submission Form (private)	Form	Modified	IACUC General Submission Form
205405	IACUC General Submission Form (state and local)	Form	Modified	IACUC General Submission Form

ICR Details

OMB Control No: 1024-0265	ICR Reference No: 201509-1024-003
Status: Historical Active	Previous ICR Reference No: 201301-1024-001
Agency/Subagency: DOI/NPS	Agency Tracking No:
Title: NPS Institutional Animal Care and Use Committee (IACUC) General Submission, Exhibitor, Annual Review, and Amendment Forms
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/11/2016
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/30/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2019	36 Months From Approved	08/31/2016
Responses	230	0	190
Time Burden (Hours)	140	0	348
Cost Burden (Dollars)	0	0	0

---

Abstract: All research, teaching, and training projects involving the use and care of vertebrate animals taking place on NPS territories must be reviewed and approved by the NPS IACUC prior to starting. Principal Investigators (PI) are required to submit one of the following forms for consideration by the committee: • The NPS IACUC General Submission (GS) form • The NPS IACUC Field Study/BioBlitz form • The NPS IACUC Concurrence Review form • The NPS IACUC Amendment form • The NPS IACUC Annual Review form

---

Authorizing Statute(s): PL: Pub.L. 89 - 544 1 Name of Law: Animal Welfare Act (AWA) of 1966
   US Code: 16 USC a-1 Name of Law: NPS Organic Act
  

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:
	81 FR 1642	01/13/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 17735	03/30/2016
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 10

table that charts list of burden

IC Title	Form No.	Form Name
IACUC Amendment Form (private)	10-1301A	IACUC Amendment Form
IACUC Amendment Form (state and local)	10-1301A	IACUC Amendment Form
IACUC Annual Review Form (private)	10-1302	IACUC Annual Review Form
IACUC Annual Review Form (state and local)	10-1302	IACUC Annual Review Form
IACUC Concurrence Form (private)	10-1303	IACUC Concurrence Form
IACUC Concurrence Form (state and local)	10-1303	IACUC Concurrence Form
IACUC Exhibitor Submission Form (private)	N/A	IACUC Exhibitor Submission Form
IACUC Exhibitor Submission Form (state and local)	N/A	IACUC Exhibitor Submission Form
IACUC Field Study/BioBlitz Form (State and Local)	10-1304	IACUC BioBlitz Field Study Form
IACUC Field Study/BioBlitz Form (private)	10-1304	IACUC BioBlirz Study Form
IACUC General Submission Form (private)	10-1301	IACUC General Submission Form
IACUC General Submission Form (state and local)	10-1301	IACUC General Submission Form

---

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	230	190	0	61	-21	0
Annual Time Burden (Hours)	140	348	0	-27	-181	0
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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Modifications to the General Submission, Amendment, and Annual Review Forms, resulted in an overall net decrease of 31 respondents and a net decrease of 186 hours from our previously approved request for these forms. The discontinued use of the exhibitor’s form, due to clarification in the scope and responsibilities of the IACUC oversight of activities in NPS units which do not extend to exhibition activities. This caused program change with decreased the overall number of respondents by 20 respondent and the burden by 60 hours. The addition of the new Concurrence Form and Field Study/BioBlitz Forms added 91 new respondents and 38 new burden hours.

---

Annual Cost to Federal Government: $224,036

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: 03/30/2016

---