GSA Mentor-Protege Program; GSA Form 3695; GSAR Subpart Affected: 519.70

Forms and Documents

Document Name	Status
Form GSA 3695 GSA Mentor-Protege Program; GSAR Subpart Affected: 519.70 Form and Instruction	Modified
3090-0286 Supporting Statement.doc Supporting Statement A	2015-12-14

IC Document Collections

IC ID	Document Title	Status
189072	GSA Mentor-Protege Program; GSAR Subpart Affected: 519.70 Form and Instruction	Modified

ICR Details

OMB Control No: 3090-0286	ICR Reference No: 201510-3090-003
Status: Historical Active	Previous ICR Reference No: 201202-3090-004
Agency/Subagency: GSA	Agency Tracking No:
Title: GSA Mentor-Protege Program; GSA Form 3695; GSAR Subpart Affected: 519.70
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 12/21/2015
	Date Received in OIRA: 11/20/2015
Terms of Clearance: This collection is approved based on the revised materials provided by the Agency.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2018	36 Months From Approved	12/31/2015
Responses	1,016	0	1,200
Time Burden (Hours)	3,048	0	3,600
Cost Burden (Dollars)	126,187	0	0

---

Abstract: In accordance with the Small Business Act, it is the policy of the Government to provide maximum practicable opportunities in its acquisitions to small business, veteran-owned small business, service-disabled veteran-owned small business, Historically Underutilized Business Zone (HUBZone)small business, small disadvantaged business, and women-owned small business concerns. Such concerns must also have the maximum practicable opportunity to participate as subcontractors in the contracts awarded by any executive agency. The purpose of implementing the General Services Mentor-Protégé Program is to assist in this policy by encouraging GSA prime contractors to assist small businesses in enhancing their capabilities to perform contracts and subcontracts.

---

Authorizing Statute(s): US Code: 40 USC 121(c) Name of Law: Administrative
  

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:
	80 FR 27310	05/13/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 46583	08/05/2015
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
GSA Mentor-Protege Program; GSAR Subpart Affected: 519.70	GSA 3695	GSA Mentor Protege Program Application

---

ICR Summary 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	1,016	1,200	0	-184	0	0
Annual Time Burden (Hours)	3,048	3,600	0	-552	0	0
Annual Cost Burden (Dollars)	126,187	0	0	126,187	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: GSA estimated the burden of the information collection on data obtained from subject matter experts in the Mentor-Protégé Program in GSA’s Office of Small Business Utilization. The burden addressed in this information collection requirement applies to the Mentor-Protégé Application and Agreement as well as the mandatory semi-annual reports for mentors and protégés as required under GSAR 519.7015. The burden hours estimated includes the time for reviewing instructions, search existing data sources, gathering and maintaining the data needed, and completing and reviewing various responses.

---

Annual Cost to Federal Government: $42,062

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: 11/20/2015

---