RI 38-47, Information and Instructions on Your Reconsideration Rights

Forms and Documents

Document Name	Status
Form RI 38-47 Information and Instructions on Your Reconsideration Rights Form	Modified
RI38-047_2016_07_MarkUp.pdf Supplementary Document	2017-05-18
RI38-047_OMB_SupportingStmt_2016_07_28.doc Supporting Statement A	2017-05-18
Ri 38-47 60_Day FRN Vol 81, no 96 31267.pdf Supplementary Document	2017-04-07
RI 38-47 30 Day FRN 2016-24791 2 _VOL 81, 70711 10_13_2016.pdf Supplementary Document	2017-01-10

IC Document Collections

IC ID	Document Title	Status
33757	Information and Instructions on Your Reconsideration Rights Form	Modified

ICR Details

OMB Control No: 3206-0237	ICR Reference No: 201701-3206-006
Status: Active	Previous ICR Reference No: 201407-3206-002
Agency/Subagency: OPM	Agency Tracking No:
Title: RI 38-47, Information and Instructions on Your Reconsideration Rights
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/01/2017
	Date Received in OIRA: 05/22/2017
Terms of Clearance: When this form is next submitted for OMB review, OPM should include a privacy act statement on the form.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2020	36 Months From Approved	10/31/2017
Responses	3,100	0	3,100
Time Burden (Hours)	2,325	0	2,325
Cost Burden (Dollars)	0	0	0

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Abstract: RI 38-47 is designed as an enclosure to be mailed with adverse initial decisions so that the person affected will understand how to request reconsideration. If this information were not provided, OPM would fail to inform the individual of how to ask for a review of the initial decision. There are minor non-substantial changes made to the room numbers and zip codes.

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Authorizing Statute(s): None

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 31267	05/18/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 70711	10/13/2016
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Information and Instructions on Your Reconsideration Rights	RI 38-47	Information and Instructions on Your Reconsideration Rights

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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	3,100	3,100	0	0	0	0
Annual Time Burden (Hours)	2,325	2,325	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $182,300

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.     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: 05/22/2017

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