State Exchange on Employment and Disability Initiative Evaluation

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
1230-NEW Supporting Statement A 5_9 SEED.docx	Supporting Statement A	Uploaded 2017-05-09	Available
SEED OMB Package Part B 12-1 ch FINAL.docx	Supporting Statement B	Uploaded 2016-12-20	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
224921	State Exchange on Employment and Disability (SEED) Evaluation Survey	Instruction	New

ICR Details

OMB Control No: 1230-0011	ICR Reference No: 201612-1230-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOL/ODEP	Agency Tracking No:
Title: State Exchange on Employment and Disability Initiative Evaluation
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 without change	Conclusion Date: 08/16/2017
	Date Received in OIRA: 05/19/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2020	36 Months From Approved
Responses	500	0	0
Time Burden (Hours)	108	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Information collection is being requested for a brief on-line survey, the “State Exchange on Employment and Disability (SEED) Initiative Implementation Evaluation Survey” that will aid in the formative evaluation of U.S. Department of Labor (DOL) Office of Disability Employment Policy’s (ODEP) State Exchange on Employment and Disability (SEED) initiative. The SEED initiative is designed to advance policy development at the state and local levels to promote employment opportunities for people with disabilities. This survey will be distributed to a sample of State legislators and their staff who have had the opportunity to participate in SEED related activities and/or learn about SEED through various dissemination activities.

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Authorizing Statute(s): PL: Pub.L. 114 - 113 Division H, Title I Sec.107 Name of Law: Consolidated Appropriations Act, 2016
  

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:
	81 FR 84618	11/23/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 23074	05/19/2017
Did the Agency receive public comments on this ICR? Yes

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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
State Exchange on Employment and Disability (SEED) Evaluation Survey

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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	500	0	0	500	0	0
Annual Time Burden (Hours)	108	0	0	108	0	0
Annual Cost Burden (Dollars)	0	0	0	0	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.

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Annual Cost to Federal Government: $284,500

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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: 05/19/2017

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