United States Naval Academy Candidate Application Forms

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form USNA 5500 Police Record Check	Form	Modified	Available
Form USNA 1110 Candidate Interview Protocol	Form	Modified	Available
N01531-1 (3-16-16).PDF	Supplementary Document	Uploaded 2016-11-28	Available
USNA Candidate Application SSN Justification (1) (1).pdf	Supplementary Document	Uploaded 2016-11-01	Available
Instrument Supplementary Letter 3.pdf	Supplementary Document	Uploaded 2016-10-31	Available
Instrument Supplementary Letter 2.pdf	Supplementary Document	Uploaded 2016-10-31	Available
Instrument Supplementary Letter 1.pdf	Supplementary Document	Uploaded 2016-10-31	Available
0703-0036 Supporting Statement A [Final].docx	Supporting Statement A	Uploaded 2016-10-31	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
5226	United States Naval Academy Candidate Application Forms	Form	Modified	Police Record Check
5226	United States Naval Academy Candidate Application Forms	Form	Modified	Candidate Interview Protocol
5226	United States Naval Academy Candidate Application Forms	Other-Instrument Mock-Up Screenshots	Modified

ICR Details

OMB Control No: 0703-0036	ICR Reference No: 201610-0703-003
Status: Historical Inactive	Previous ICR Reference No: 200709-0703-002
Agency/Subagency: DOW/NAVY	Agency Tracking No:
Title: United States Naval Academy Candidate Application Forms
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Disapproved	Conclusion Date: 02/22/2017
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/01/2016
Terms of Clearance: This collection should be resubmitted with the correct racial and ethic categories per OMB guidance on these matters.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		36 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The information is collected to determine the eligibility, overall competitive standing, scholastic, and leadership potential of candidates for an appointment to the USNA. An analysis of the information collected is made by the Admissions Board during the process in order to gauge the qualifications of individual candidates. Respondents are high school or college students applying for admission to the USNA, officials assisting with the application process, Chain of Command officials for active duty applicants, Blue and Gold Officers, and local law enforcement officials.

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Authorizing Statute(s): US Code: 10 USC Chaper 603, Section 6958 Name of Law: Midshipmen: Qualifications for Admission
  

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 61191	10/09/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 75385	10/31/2016
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
United States Naval Academy Candidate Application Forms	USNA 1110, USNA 5500	Candidate Interview Protocol ,   Police Record Check

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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 reinstatement, with change, of a previously approved collection for which approval has expired. Change in burden from the last approval of this collection and the publishing of the 60-Day FRN is due to an increase in respondents, as well as a better evaluation of the respondents and their time.

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Annual Cost to Federal Government: $2,190,750

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: 11/01/2016

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