FORM 14: ELECTRONIC SUBMISSION OF ALLEGATIONS AND DISCLOSURES

Forms and Documents

Document Name	Status
Form OSC FORM-14 FORM 14: ELECTRONIC SUBMISSION OF ALLEGATIONS AND DISCLOSURES Form	Modified
Form 14 PPRA Supporting Statement (Final).pdf Supporting Statement A	2017-01-31

IC Document Collections

IC ID	Document Title	Status
223438	FORM 14: ELECTRONIC SUBMISSION OF ALLEGATIONS AND DISCLOSURES Form	Modified

ICR Details

OMB Control No: 3255-0005	ICR Reference No: 201701-3255-001
Status: Historical Inactive	Previous ICR Reference No: 201609-3255-001
Agency/Subagency: OSC	Agency Tracking No: OSC FORM-14
Title: FORM 14: ELECTRONIC SUBMISSION OF ALLEGATIONS AND DISCLOSURES
Type of Information Collection: Existing collection in use without an OMB Control Number	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn	Conclusion Date: 03/21/2017
	Date Received in OIRA: 01/31/2017
Terms of Clearance:

	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: THIS FORM WILL REPLACE FORMS OSC-11, OSC-12, AND OSC-13, WHICH WERE PREVIOUSLY APPROVED BY OMB. THE NEW ELECTRONIC FORM WILL BE USED BY CURRENT AND FORMER FEDERAL EMPLOYEES AND APPLICANTS FOR FEDERAL EMPLOYMENT, AND OTHER COVERED FILERS, TO SUBMIT ALLEGATIONS OF POSSIBLE PROHIBITED PERSONNEL PRACTICES OR OTHER PROHIBITED ACTIVITIES FOR INVESTIGATION AND POSSIBLE PROSECUTION BY OSC, OR REVIEW AND POSSIBLE REFERRAL TO RELEVANT INSPECTOR GENERAL OFFICES.

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Authorizing Statute(s): US Code: 5 USC CFR 1800 Name of Law: CODE OF REGULATIONS
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
3255-AA00	Final or interim final rulemaking	81 FR 60649	09/02/2016

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 60649	09/02/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 60649	09/02/2016
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
FORM 14: ELECTRONIC SUBMISSION OF ALLEGATIONS AND DISCLOSURES	OSC FORM-14	FORM 14: ELECTRONIC SUBMISSION OF ALLEGATIONS AND DISCLOSURES

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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 FORM WILL REPLACE FORMS OSC-11, OSC-12, AND OSC-13, WHICH WERE PREVIOUSLY APPROVED BY OMB. THE NEW ELECTRONIC FORM WILL BE USED BY CURRENT AND FORMER FEDERAL EMPLOYEES AND APPLICANTS FOR FEDERAL EMPLOYMENT, AND OTHER COVERED FILERS, TO SUBMIT ALLEGATIONS OF POSSIBLE PROHIBITED PERSONNEL PRACTICES OR OTHER PROHIBITED ACTIVITIES FOR INVESTIGATION AND POSSIBLE PROSECUTION BY OSC, OR REVIEW AND POSSIBLE REFERRAL TO RELEVANT INSPECTOR GENERAL OFFICES.

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Annual Cost to Federal Government: $0

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? 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: 01/31/2017

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