Conference, Meeting, Workshop, and Poster Session Registration Generic Clearance (OD)

Forms and Documents

Document Name	Status
Form 1 The Cognition and Medical Image Perception Think Tank Registration Form (NCI) Form and Instruction	New
Form 1 Workshop Registration and Abstract for Collaborations in Metabolomics Event (NCI) Form and Instruction	New
Form 1 DCCPS Fellows Symposium Submission (NCI) Form and Instruction	New
Form 1 Division of Cancer Control and Population Sciences and Division of Cancer Prevention 2019 New Grantee Workshop, November 21-22,2019 (NCI) Form and Instruction	New
Form 1 2019 Hackathon Workshops Application (NLM) Form and Instruction	New
Form 1 Frontiers in Light Microscopy - Multiscale Imaging: From Organelles to Organisms (NCI) Form and Instruction	New
Form 1 Center of Excellence in Chromosome Biology (CECB), Chromatin and Cell Fate Decisions in Development, Aging & Cancer Conference (NCI) Form and Instruction	New
Form 1 2019 Women-led Biodata Science Hackathon Application (NLM) Form and Instruction	New
Form 1 Outreach Partnership Program Annual Meeting Registration Form (NIMH) Form and Instruction	New
Form 1 12th Annual Frontiers in Chemistry and Biology Interface Symposium (NCI) Form and Instruction	New
Form 1 2019 Nonprofit Forum Registration (NINDS) Form	New
Form 1 2019 Myalgic Encephalomyeliti/Chronic Fatigue Syndrome (ME/CFS) Young Investigators Travel Awards Workshop (NINDS) Form and Instruction	New
Form 1 Scientific abstract collection for the 2019 High-Risk, High-Reward Research Symposium (OD) Form	New
Form 1 Registration for Workshop to Facilitate Cancer Systems Epidemiology Research (NCI) Form	New
Form 1 Application and registration information collection for the Mary Frances Picciano Dietary Supplement Research Practicum (DSRP) on May 29–31, 2019 at the Lister Hill Auditorium (NLM) Form	New
Form 1 Application and registration information collection for the Mary Frances Picciano Dietary Supplement Research Practicum (DSRP) on May 29–31, 2019 at the Lister Hill Auditorium (NLM) Form	New
Form 1 2019 Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Principle Investigators (PI) Conference Registration (NINDS) Form and Instruction	New
Form 1 Non-profit organizations with interest in supporting research sign-up (NIDA) Form	New
Form 1 RNA Biology workshop (NCI) Form	New
Form 1 5th NCI Pancreatic Cancer Symposium Form	New
Form 1 NIH Common Fund SPARC Program Abstract Collection for ISAN 2019 Meeting Form	New
Form 1 Specialized Programs of Research Excellence (SPORE) REVISED Contact Information Form (NCI) Form	New
Form 1 Registration and Abstract Submission for the NCI Cohort Consortium 2018 Annual Meeting (NCI) Form and Instruction	New
Form 1 Specialized Programs of Research Excellence (SPORE) Contact Information Form (NCI) Form	New
Form 1 Registration and Abstract Submission for Poster Session for Metabolomics Meeting Form and Instruction	New
Form 1 NIMH Mental Health Services Research Conference Registration Form and Instruction	New
Form 1 Sandpit Workshop Form	New
Form 1 Office of Intramural Training & Education (OITE) – How to Teach and Advise on Career Development Topics for the Next Generation of Biomedical Scientists: A Train-the-Trainers Event – Abstract Form	New
Form 1 Office of Intramural Training & Education (OITE) – How to Teach and Advise on Career Development Topics for the Next Generation of Biomedical Scientists: A Train-the-Trainers Event Form	New
Form 1 Scientific abstract collectrion for the 2018 High-Risk, High-Reward Research Symposium Form and Instruction	New
Form 1 Application for NIH Support to Participate in NHLBI-funded Training Workshop Form	New
Form 1 NIH Office of Intramural Training & Education (OITE) - International Opportunities Expo - Exhibitor Registration Form	New
Form 1 Office of Intramural Training & Education (OITE) - Community College Summer Enrichment Program (CCSEP) and College Summer Opportunities in Advanced Research (C-SOAR) Alumni Database Form	New
Form 1 HINTS Workshop Sub-Study Form	New
Form 1 2018 Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Principle Investigators (PIs) Meeting Conference Registration Form	New
Form 1 Sandpit Workshop Form and Instruction	New
Form 1 Health Disparities Research Institute (HDRI) Course Assessment Form	New
Form 1 Office of Intramural Training & Education (OITE) – HiSTEP Alumni Database Form and Instruction	New
Form 1 The National Institute of Neurological Disorders and Stroke (NINDS) Landis Award for Outstanding Mentorship Form and Instruction	New
Form 1 Demographic Information Survey for Applicants to NIH Training and Fellowship Programs Form and Instruction	New
Form 1 Demographic Information Survey on NIH Traninees/Fellows Form	New
Form 1 NIMH Outreach Partnership Program Annual Meeting Registration Form and Instruction	New
Form 1 NIMH Computational Psychiatry Workshop Registration Form and Instruction	New
Form 1 NIMH Global Mental Health Conference Registration (Private Sector) Form and Instruction	New
Form 1 NIMH Global Mental Health Conference Registration (Individuals) Form and Instruction	New
Form 1 Health Disparities Research Institute (HDRI) (NIMHD) Form and Instruction	New
Form 1 Annual Norman P. Salzman Memorial Award and Symposium in Virology Form	New
Form 1 2016 Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Principle Investigators' (PI) Meeting Conference Registration (NINDS) Form and Instruction	New
Form 1 Annual Norman P. Salzman Memorial Award and Symposium in Virology Form	New
Form 1 Office of Intramural Training & Education (OITE) – Alumni Database for Former NIH Trainees Form and Instruction	New
Form 1 NIMH Office Constituency Relations and Public Liaison (OCRPL) - Outreach and Engagement Activities Registration Form and Instruction	New
Form 1 LRP Ambassador Sign-up and Consent Form	New
Form 1 Application for NIH Support to Participate in Industry and Investor Showcase Events Form and Instruction	New
Form 1 NIH Office of Intramural Training & Education (OITE) – Graduate & Professional School Fair - Exhibitor Registration Form	New
Form 1 Office of Intramural Training & Education (OITE) – Graduate Award Certificate Registration Form and Instruction	New
Form 1 NIH Office of Intramural Training & Education (OITE) – NIH Community College Day Registration Form	New
Form 1 NIH Office of Intramural Training & Education (OITE) – MyOITE Account Registration Form	New
Form 1 NIH Office of Intramural Training & Education (OITE) – Graduate & Professional School Fair - Student Registration Form	New
Sub-Study Template Example.doc Supplementary Document	2016-05-26
Attachment 2 example registration form (2).docx Supplementary Document	2016-02-01
Attachment 1 example of Poster abstracts.pdf Supplementary Document	2016-02-01
Generic Clearance Currie 12-29-15.pdf Supplementary Document	2016-02-01
2016-01555.pdf Supplementary Document	2016-02-01
Abstracts Supporting Statement A-2016.docx Supporting Statement A	2016-02-01

IC Document Collections

IC ID	Document Title	Status
236265	The Cognition and Medical Image Perception Think Tank Registration Form (NCI) Form and Instruction	New
236112	Workshop Registration and Abstract for Collaborations in Metabolomics Event (NCI) Form and Instruction	New
236105	DCCPS Fellows Symposium Submission (NCI) Form and Instruction	New
236102	Division of Cancer Control and Population Sciences and Division of Cancer Prevention 2019 New Grantee Workshop, November 21-22,2019 (NCI) Form and Instruction	New
235935	2019 Hackathon Workshops Application (NLM) Form and Instruction	New
235916	Frontiers in Light Microscopy - Multiscale Imaging: From Organelles to Organisms (NCI) Form and Instruction	New
235836	Center of Excellence in Chromosome Biology (CECB), Chromatin and Cell Fate Decisions in Development, Aging & Cancer Conference (NCI) Form and Instruction	New
235620	2019 Women-led Biodata Science Hackathon Application (NLM) Form and Instruction	New
235603	Outreach Partnership Program Annual Meeting Registration Form (NIMH) Form and Instruction	New
235491	12th Annual Frontiers in Chemistry and Biology Interface Symposium (NCI) Form and Instruction	New
235302	2019 Nonprofit Forum Registration (NINDS) Form	New
234905	2019 Myalgic Encephalomyeliti/Chronic Fatigue Syndrome (ME/CFS) Young Investigators Travel Awards Workshop (NINDS) Form and Instruction	New
234818	Scientific abstract collection for the 2019 High-Risk, High-Reward Research Symposium (OD) Form	New
234746	Registration for Workshop to Facilitate Cancer Systems Epidemiology Research (NCI) Form	New
234162	Application and registration information collection for the Mary Frances Picciano Dietary Supplement Research Practicum (DSRP) on May 29–31, 2019 at the Lister Hill Auditorium (NLM) Form	New
234157	Application and registration information collection for the Mary Frances Picciano Dietary Supplement Research Practicum (DSRP) on May 29–31, 2019 at the Lister Hill Auditorium (NLM) Form	New
233713	2019 Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Principle Investigators (PI) Conference Registration (NINDS) Form and Instruction	New
233239	Non-profit organizations with interest in supporting research sign-up (NIDA) Form	New
233212	RNA Biology workshop (NCI) Form	New
233181	5th NCI Pancreatic Cancer Symposium Form	New
232991	NIH Common Fund SPARC Program Abstract Collection for ISAN 2019 Meeting Form	New
232667	Specialized Programs of Research Excellence (SPORE) REVISED Contact Information Form (NCI) Form	New
232577	Registration and Abstract Submission for the NCI Cohort Consortium 2018 Annual Meeting (NCI) Form and Instruction	New
232449	Specialized Programs of Research Excellence (SPORE) Contact Information Form (NCI) Form	New
231417	Registration and Abstract Submission for Poster Session for Metabolomics Meeting Form and Instruction	New
230908	NIMH Mental Health Services Research Conference Registration Form and Instruction	New
230872	Sandpit Workshop Form	New
230501	Office of Intramural Training & Education (OITE) – How to Teach and Advise on Career Development Topics for the Next Generation of Biomedical Scientists: A Train-the-Trainers Event – Abstract Form	New
230500	Office of Intramural Training & Education (OITE) – How to Teach and Advise on Career Development Topics for the Next Generation of Biomedical Scientists: A Train-the-Trainers Event Form	New
230241	Scientific abstract collectrion for the 2018 High-Risk, High-Reward Research Symposium Form and Instruction	New
230112	Application for NIH Support to Participate in NHLBI-funded Training Workshop Form	New
230086	NIH Office of Intramural Training & Education (OITE) - International Opportunities Expo - Exhibitor Registration Form	New
229702	Office of Intramural Training & Education (OITE) - Community College Summer Enrichment Program (CCSEP) and College Summer Opportunities in Advanced Research (C-SOAR) Alumni Database Form	New
228815	HINTS Workshop Sub-Study Form	New
228777	2018 Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Principle Investigators (PIs) Meeting Conference Registration Form	New
228515	Sandpit Workshop Form and Instruction	New
227469	Health Disparities Research Institute (HDRI) Course Assessment Form	New
227439	Office of Intramural Training & Education (OITE) – HiSTEP Alumni Database Form and Instruction	New
227341	The National Institute of Neurological Disorders and Stroke (NINDS) Landis Award for Outstanding Mentorship Form and Instruction	New
226444	Demographic Information Survey for Applicants to NIH Training and Fellowship Programs Form and Instruction	New
226289	Demographic Information Survey on NIH Traninees/Fellows Form	New
226280	NIMH Outreach Partnership Program Annual Meeting Registration Form and Instruction	New
226222	NIMH Computational Psychiatry Workshop Registration Form and Instruction	New
225994	NIMH Global Mental Health Conference Registration (Private Sector) Form and Instruction	New
225993	NIMH Global Mental Health Conference Registration (Individuals) Form and Instruction	New
225774	Health Disparities Research Institute (HDRI) (NIMHD) Form and Instruction	New
223756	Annual Norman P. Salzman Memorial Award and Symposium in Virology Form	New
223399	2016 Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Principle Investigators' (PI) Meeting Conference Registration (NINDS) Form and Instruction	New
223380	Annual Norman P. Salzman Memorial Award and Symposium in Virology Form	New
223054	Office of Intramural Training & Education (OITE) – Alumni Database for Former NIH Trainees Form and Instruction	New
222961	NIMH Office Constituency Relations and Public Liaison (OCRPL) - Outreach and Engagement Activities Registration Form and Instruction	New
222744	LRP Ambassador Sign-up and Consent Form	New
222512	Application for NIH Support to Participate in Industry and Investor Showcase Events Form and Instruction	New
222356	NIH Office of Intramural Training & Education (OITE) – Graduate & Professional School Fair - Exhibitor Registration Form	New
222276	Office of Intramural Training & Education (OITE) – Graduate Award Certificate Registration Form and Instruction	New
222176	NIH Office of Intramural Training & Education (OITE) – NIH Community College Day Registration Form	New
222168	NIH Office of Intramural Training & Education (OITE) – MyOITE Account Registration Form	New
222100	NIH Office of Intramural Training & Education (OITE) – Graduate & Professional School Fair - Student Registration Form	New

ICR Details

OMB Control No: 0925-0740	ICR Reference No: 201602-0925-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: Conference, Meeting, Workshop, and Poster Session Registration Generic Clearance (OD)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 05/26/2016
	Date Received in OIRA: 02/02/2016
Terms of Clearance: All GenICs submitted under this Generic will have an accompanying memo (see template in supplementary documents) and instrument.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2019	36 Months From Approved
Responses	34,500	0	0
Time Burden (Hours)	26,625	0	0
Cost Burden (Dollars)	390,415	0	0

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Abstract: The National Institutes of Health (NIH) directly sponsors, organizes, and conducts research-related activities such as conferences, workshops, meetings, poster sessions, and training courses. These activities are designed to be relevant to the current state of research in a given field or to the current stage of participants’ research projects or careers, and other resource limitations also determine the number of possible participants. In order for such activities to be timely and to optimally use available resources to address needs and opportunities within the research community, it is necessary for NIH to have a means to register and select the most appropriate participants, according to the type or purpose of a given activity. NIH is requesting a 3 year generic clearance to provide a quick and efficient process to create registration forms for NIH sponsored conference, meetings, workshops meetings, poster sessions, presentations and panels.

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Authorizing Statute(s): US Code: 42 USC 258 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:
	80 FR 45541	07/30/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 4315	01/26/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 58

IC Title	Form No.	Form Name
NIMH Office Constituency Relations and Public Liaison (OCRPL) - Outreach and Engagement Activities Registration	1	OCRPL Outreach and Engagement Activities Registration Form
Demographic Information Survey on NIH Traninees/Fellows	1	EDI Demographic Form for NIH Trainees and Fellows
The National Institute of Neurological Disorders and Stroke (NINDS) Landis Award for Outstanding Mentorship	1	Landis Instrument
Office of Intramural Training & Education (OITE) - Community College Summer Enrichment Program (CCSEP) and College Summer Opportunities in Advanced Research (C-SOAR) Alumni Database	1	CCSEP-CSOAR-Alumni
2019 Nonprofit Forum Registration (NINDS)	1	NINDS Nonprofit Forum Registration Questions
NIH Office of Intramural Training & Education (OITE) – MyOITE Account Registration	4, 3, 2, 1	MyOITE Trainee ,   MyOITE-Staff ScientistClinician ,   MyOITE-OtherStaffNIH ,   MyOITE-Guest
LRP Ambassador Sign-up and Consent	1	LRP Ambassador Sign-up Form
Annual Norman P. Salzman Memorial Award and Symposium in Virology	1	Registration Form
Health Disparities Research Institute (HDRI) (NIMHD)	1	HDRI Application 2017
Office of Intramural Training & Education (OITE) – HiSTEP Alumni Database	1	OMBFT- HiSTEP- Alumni
2018 Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Principle Investigators (PIs) Meeting Conference Registration	1, 3, 2	General Attendees Registration ,   Investigator Registration and Abstract Path ,   Trainee Registration and Abstract Path
NIH Office of Intramural Training & Education (OITE) - International Opportunities Expo - Exhibitor Registration	1	OITE International Expo Exhibitor Registration
Registration and Abstract Submission for Poster Session for Metabolomics Meeting	1, 2	COMETS Abstract submission ,   COMETS Registration site
2019 Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Principle Investigators (PI) Conference Registration (NINDS)	2, 1, 3	Scientist registration and abstract submission ,   Trainee registration and abstract submission ,   General attendee registration
Application and registration information collection for the Mary Frances Picciano Dietary Supplement Research Practicum (DSRP) on May 29–31, 2019 at the Lister Hill Auditorium (NLM)	1	ODS DSRP Application 2019
Annual Norman P. Salzman Memorial Award and Symposium in Virology	1	Attachment 1 Abstract Application
NIMH Computational Psychiatry Workshop Registration	1	NIMH Computational Psychiatry Workshop Registration Form
NIMH Outreach Partnership Program Annual Meeting Registration	1, 1, 1	OPP Annual Meeting- Sponsored Presenters Registration Form Data ,   OPP Annual Meeting- Sponsored Participants Registration Form Data ,   OPP Annual Meeting- Non-Sponsored Participants Registration Form Data
Application for NIH Support to Participate in NHLBI-funded Training Workshop	1	Saunders-Watkins 2018 Application
Frontiers in Light Microscopy - Multiscale Imaging: From Organelles to Organisms (NCI)	1	Registration Page
2019 Hackathon Workshops Application (NLM)	1	2019 Hackathon application instrument
Center of Excellence in Chromosome Biology (CECB), Chromatin and Cell Fate Decisions in Development, Aging & Cancer Conference (NCI)	1, 2	Abstract page ,   Registration page
DCCPS Fellows Symposium Submission (NCI)	1, 2	Registration and Abstract Submission Form screenshot ,   Mentor of the Year award form screenshot
NIH Office of Intramural Training & Education (OITE) – Graduate & Professional School Fair - Student Registration	1, 2	Graduate and Professional School Fair Student Registration- NIH ,   Graduate and Professional School Fair Student Registration- Non NIH
NIH Office of Intramural Training & Education (OITE) – NIH Community College Day Registration	1, 2	Individual Student Registration ,   Faculty Registration
NIH Office of Intramural Training & Education (OITE) – Graduate & Professional School Fair - Exhibitor Registration	1	Graduate and Professional School Fair Exhibitor Registration Collection
Office of Intramural Training & Education (OITE) – Alumni Database for Former NIH Trainees	1	OMBFT Alumni Database Registration Collection
Health Disparities Research Institute (HDRI) Course Assessment	1	HDRI Assessment
NIMH Mental Health Services Research Conference Registration	1, 2	MHSR Abstract Submission form ,   MHSR Participant Registration form
Registration and Abstract Submission for the NCI Cohort Consortium 2018 Annual Meeting (NCI)	1	Cohort Consortium Form
Specialized Programs of Research Excellence (SPORE) REVISED Contact Information Form (NCI)	1	Revised SPORE
5th NCI Pancreatic Cancer Symposium	2, 1	Attendee Registration ,   Abstract Application
2019 Myalgic Encephalomyeliti/Chronic Fatigue Syndrome (ME/CFS) Young Investigators Travel Awards Workshop (NINDS)	1	How to Apply for Travel Award Form
RNA Biology workshop (NCI)	1	Registration Screenshot
Scientific abstract collection for the 2019 High-Risk, High-Reward Research Symposium (OD)	1	HRHR Symposium abstract submission
Registration for Workshop to Facilitate Cancer Systems Epidemiology Research (NCI)	1	Registration Epi Research Workshop
Outreach Partnership Program Annual Meeting Registration Form (NIMH)	1	2019 OPP Registration Form and Questions
Workshop Registration and Abstract for Collaborations in Metabolomics Event (NCI)	1	Registration & Abstract screenshot
The Cognition and Medical Image Perception Think Tank Registration Form (NCI)	1	Cognitive Think Tank Registration Form
Office of Intramural Training & Education (OITE) – Graduate Award Certificate Registration	1	Award Certificate Registration Collection
Office of Intramural Training & Education (OITE) – How to Teach and Advise on Career Development Topics for the Next Generation of Biomedical Scientists: A Train-the-Trainers Event – Abstract	1	OITE TrainTrainers - Abstract
Demographic Information Survey for Applicants to NIH Training and Fellowship Programs	1	EDI Demographic Form of Applicants to NIH Training and Fellowship Program Survey
Scientific abstract collectrion for the 2018 High-Risk, High-Reward Research Symposium	1	HRHR Symposium Abstract Submission Page
Non-profit organizations with interest in supporting research sign-up (NIDA)	1	Sign-Up Form
12th Annual Frontiers in Chemistry and Biology Interface Symposium (NCI)	1, 2	Registration submission page ,   Abstract submission page
Office of Intramural Training & Education (OITE) – How to Teach and Advise on Career Development Topics for the Next Generation of Biomedical Scientists: A Train-the-Trainers Event	1, 2	OITE- Train Trainers - Interest ,   OITE Train Trainers - Registration
Specialized Programs of Research Excellence (SPORE) Contact Information Form (NCI)	1	TRP Contact Information Form
NIH Common Fund SPARC Program Abstract Collection for ISAN 2019 Meeting	1	SPARC at ISAN 2019 Abstract Management Screenshot
Application and registration information collection for the Mary Frances Picciano Dietary Supplement Research Practicum (DSRP) on May 29–31, 2019 at the Lister Hill Auditorium (NLM)	1	ODS DSRP Registration
2019 Women-led Biodata Science Hackathon Application (NLM)	1	Women-led Hackathon Application instrument
Division of Cancer Control and Population Sciences and Division of Cancer Prevention 2019 New Grantee Workshop, November 21-22,2019 (NCI)	1, 2	new Grantee Wkshop Registration/Abstract ,   Assessment Form
Application for NIH Support to Participate in Industry and Investor Showcase Events	1	Application to Participate in Industry and Investor Showcase Events
2016 Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Principle Investigators' (PI) Meeting Conference Registration (NINDS)	2, 1, 3	Investigator or trainee for a federally funded BRAIN project (abstract submitters) ,   Investigator or trainee for a federally funded BRAIN project ,   Other or other BRAIN-related investigator or trainee
NIMH Global Mental Health Conference Registration (Private Sector)	1	GMH Conference Registration Form
NIMH Global Mental Health Conference Registration (Individuals)	1	GMH Conference Registration Form
Sandpit Workshop	1	Sandpit Research Call 2018
HINTS Workshop Sub-Study	1, 2	Abstract Submission Screenshot ,   Registration Screenshot
Sandpit Workshop	1	2018 CRUNK-NCI sandpit research call

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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	34,500	0	0	34,500	0	0
Annual Time Burden (Hours)	26,625	0	0	26,625	0	0
Annual Cost Burden (Dollars)	390,415	0	0	390,415	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: No

Burden Reduction Due to:

Short Statement: This is a new information collection request.

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Annual Cost to Federal Government: $1,937

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: 02/02/2016

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