HHSAR 337.103(d)(4)

ICR 201511-0990-005

OMB: 0990-0433

Federal Form Document

Forms and Documents
Document
Name
Status
Supporting Statement A
2015-11-17
IC Document Collections
IC ID
Document
Title
Status
217364
Unchanged
ICR Details
0990-0433 201511-0990-005
Historical Active 201507-0990-005
HHS/HHSDM
HHSAR 337.103(d)(4)
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 12/02/2015
Retrieve Notice of Action (NOA) 11/18/2015
  Inventory as of this Action Requested Previously Approved
12/31/2018 36 Months From Approved
160 0 0
160 0 0
0 0 0

Performance of IHS mission requires the support of contractors. In some circumstances, depending on the requirements of the specific contract, the contractor is tasked to provide personnel who will be dealing with Indian children under the age of 18. Before working on the contract, each of these contractor personnel must undergo a background check as required by federal law (Indian Child Protection and Family Violence Act (ICPFVA)). The contractor is therefore required to provide information on the individual so that a proper background check can be performed.

US Code: 48 USC 337 Name of Law: Federal Acquisition Regulation
  
None

0991-AB86 Final or interim final rulemaking 80 FR 72149 11/18/2015

No

1
IC Title Form No. Form Name
HHSAR 337.103(d)(4)

  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 160 0 0 160 0 0
Annual Time Burden (Hours) 160 0 0 160 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
New Collection

$0
No
No
No
No
No
Uncollected
Sherette Funn-Coleman

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
11/18/2015


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