United States Park Police Pre-Employment Suitability Determination Process

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Form 10-2201F Applicant Documentation Form	Form and Instruction	New	Available
Form Form 10-2201E Physician Consent Form	Form and Instruction	New	Available
Form Form 10-2201D Physical Efficiency Battery "Waiver"	Form and Instruction	New	Available
Form Form 10-2201C Lautenberg Certification	Form and Instruction	New	Available
Form Form 10-2201B Release to Obtain a Credit Report	Form and Instruction	New	Available
Form Form 10-2201A Information Release Form	Form and Instruction	New	Available
Form Form 10-2201 Personal Qualifications Statement	Form and Instruction	Modified	Available
Rehab Act and Processing Memo with NPS Comments 8-16-17.doc	Supplementary Document	Uploaded 2017-09-25	Available
1024-0245 30-day FRN Final Published 11102016 81218 79047.pdf	Supplementary Document	Uploaded 2016-11-15	Available
1024-0245 USPP Revision SSA 11022016.docx	Supporting Statement A	Uploaded 2016-11-02	Available
1024-0245 USPP Revision 60-day FRN published 05292015 2015-13039 80103 30721.pdf	Supplementary Document	Uploaded 2016-06-28	Available
5 CFR 5.2 Investigation and evaluations.pdf	Supplementary Document	Uploaded 2016-06-28	Available
Executive Order 10450.pdf	Supplementary Document	Uploaded 2016-06-28	Available
18 USC Section 922.pdf	Supplementary Document	Uploaded 2016-06-28	Available
5 USC Section 3301.pdf	Supplementary Document	Uploaded 2016-06-28	Available
5 USC Section 1302 and 1304.pdf	Supplementary Document	Uploaded 2016-06-28	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
222243	Form 10-2201F, "Applicant Documentation Form"	Form and Instruction	New	Applicant Documentation Form
222239	Form 10-2201E, "Physician Consent Form"	Form and Instruction	New	Physician Consent Form
222238	Form 10-2201D, "Physical Efficiency Battery "Waiver"	Form and Instruction	New	Physical Efficiency Battery "Waiver"
222237	Form 10-2201C, "Lautenberg Certification"	Form and Instruction	New	Lautenberg Certification
222234	Form 10-2201B, "Release to Obtain a Credit Report"	Form and Instruction	New	Release to Obtain a Credit Report
222230	Form 10-2201A, "Information Release Form"	Form and Instruction	New	Information Release Form
11182	Form 10-2201, "Personal Qualifications Statement"	Form and Instruction	Modified	Personal Qualifications Statement
11182	Form 10-2201, "Personal Qualifications Statement"	Instruction	Modified

ICR Details

OMB Control No: 1024-0245	ICR Reference No: 201606-1024-003
Status: Historical Active	Previous ICR Reference No: 201310-1024-002
Agency/Subagency: DOI/NPS	Agency Tracking No:
Title: United States Park Police Pre-Employment Suitability Determination Process
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: 09/26/2017
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/15/2016
Terms of Clearance: Upon resubmission, the National Park Service will have made a determination about whether the collection is covered by the Privacy Act and, if so, will include all necessary supporting documentation and revisions to the collection as part of the re-submission.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2018	36 Months From Approved	09/30/2017
Responses	15,015	0	2,500
Time Burden (Hours)	19,793	0	20,000
Cost Burden (Dollars)	238,752	0	227,500

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Abstract: As part of the application process for consideration as a candidate for United States Park Police Officer positions, we collect information from applicants during the Pre-employment Suitability Determination Phase of the application process to narrow the list of potential candidates who are qualified to move to the next phase of the application process. The USPP application process consists of 6 phases: (1) Application via USAJobs.com; (2) Pre-employment Suitability Determination; (3) written examination; (4) oral interview; (5) physical and psychological evaluations; and (6) physical fitness and agility tests. Background clearances are not initiated until the candidate has successfully passed all six (6) phases of the USPP application process.

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Authorizing Statute(s): US Code: 5 USC Sections 1302 and 1304 Name of Law: Special Authority
   US Code: 5 USC Section 3301 Name of Law: Civil Service; generally
   US Code: 18 USC Section 922 Name of Law: Unlawful Acts
   EO: EO 10450 Name/Subject of EO: Security Requirements for Government Employees
  

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 30721	05/29/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 79047	11/10/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 7

table that charts list of burden

IC Title	Form No.	Form Name
Form 10-2201, "Personal Qualifications Statement"	Form 10-2201	Personal Qualifications Statement
Form 10-2201A, "Information Release Form"	Form 10-2201A	Information Release Form
Form 10-2201B, "Release to Obtain a Credit Report"	Form 10-2201B	Release to Obtain a Credit Report
Form 10-2201C, "Lautenberg Certification"	Form 10-2201C	Lautenberg Certification
Form 10-2201D, "Physical Efficiency Battery "Waiver"	Form 10-2201D	Physical Efficiency Battery "Waiver"
Form 10-2201E, "Physician Consent Form"	Form 10-2201E	Physician Consent Form
Form 10-2201F, "Applicant Documentation Form"	Form 10-2201F	Applicant Documentation Form

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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	15,015	2,500	0	12,515	0	0
Annual Time Burden (Hours)	19,793	20,000	0	-207	0	0
Annual Cost Burden (Dollars)	238,752	227,500	0	11,252	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: This is an existing collection with seven (7) new forms added which were in use without approval. USPP Form 1 was previously approved under 1024-0245 but is now officially re-designated as NPS Form 10-2201. The remaining seven (7) forms which were in use without OMB approval are assigned form numbers 10-2201A through 10-2201F. With the submission of the additional forms in use without approval, we are reporting an increase of 12.515 annual responses and a reduction of 207 burden hours. The estimate of 8 hours previously reported for this collection included the time for the applicants to complete the entire package (Form 10-2201 and the forms in use without approval) despite the additional forms not being submitted for approval. The reduction in our burden hour estimate is due to the reduced completion time of the forms. The reduced time is based on comments received during the outreach process and on past experience administering this collection. Additionally, the revised forms are more streamlined and more easily fillable in the MS Word format which should help to reduce time spent completing them. We are also reporting an increase in the nonhour annual cost burden of $11,252. This increase is due to increased costs associated with providing the required supporting documentation, as well as notary fees and costs associated with making copies of the documents.

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Annual Cost to Federal Government: $82,459

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

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: 11/15/2016

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