30-day notice

applicant 30 day 3.1.17.pdf

Applicant Background Questionnaire

30-day notice

OMB: 3046-0046

Document [pdf]
Download: pdf | pdf
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Federal Register / Vol. 82, No. 39 / Wednesday, March 1, 2017 / Notices

The filings are accessible in the
Commission’s eLibrary system by
clicking on the links or querying the
docket number.
Any person desiring to intervene or
protest in any of the above proceedings
must file in accordance with Rules 211
and 214 of the Commission’s
Regulations (18 CFR 385.211 and
385.214) on or before 5:00 p.m. Eastern
time on the specified comment date.
Protests may be considered, but
intervention is necessary to become a
party to the proceeding.
eFiling is encouraged. More detailed
information relating to filing
requirements, interventions, protests,
service, and qualifying facilities filings
can be found at: http://www.ferc.gov/
docs-filing/efiling/filing-req.pdf. For
other information, call (866) 208–3676
(toll free). For TTY, call (202) 502–8659.
Dated: February 23, 2017.
Nathaniel J. Davis, Sr.,
Deputy Secretary.
[FR Doc. 2017–03925 Filed 2–28–17; 8:45 am]
BILLING CODE 6717–01–P

EQUAL EMPLOYMENT OPPORTUNITY
COMMISSION
Agency Information Collection
Activities
Equal Employment
Opportunity Commission.
ACTION: Notice of information
collection—extension without change:
Demographic information on applicants
for Federal employment.
AGENCY:

In accordance with the
Paperwork Reduction Act, the Equal
Employment Opportunity Commission
(EEOC or Commission) announces that
it is submitting to the Office of
Management and Budget (OMB) a
request for a three-year extension
without change of the Demographic
Information on Federal Job Applicants,
OMB No. 3046–0046.
DATES: Written comments on this notice
must be submitted on or before March
31, 2017.
ADDRESSES: Comments on this notice
must be submitted to Joseph B. Nye,
Policy Analyst, Office of Information
and Regulatory Affairs, Office of
Management and Budget, 725 17th
Street NW., Washington, DC 20503,
email [email protected].
Commenters are also encouraged to
send comments to the EEOC online at
http://www.regulations.gov, which is
the Federal eRulemaking Portal. Follow
the instructions on the Web site for
submitting comments. In addition, the

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SUMMARY:

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EEOC’s Executive Secretariat will accept
comments in hard copy. Hard copy
comments should be sent to Bernadette
Wilson, Acting Executive Officer, EEOC,
131 M Street NE., Washington, DC
20507. Finally, the Executive Secretariat
will accept comments totaling six or
fewer pages by facsimile (‘‘fax’’)
machine before the same deadline at
(202) 663–4114. (This is not a toll-free
number.) Receipt of fax transmittals will
not be acknowledged, except that the
sender may request confirmation of
receipt by calling the Executive
Secretariat staff at (202) 663–4070
(voice) or (202) 663–4074 (TTY). (These
are not toll-free telephone numbers.)
The EEOC will post online at http://
www.regulations.gov all comments
submitted via this Web site, in hard
copy, or by fax to the Executive
Secretariat. These comments will be
posted without change, including any
personal information you provide.
However, the EEOC reserves the right to
refrain from posting libelous or
otherwise inappropriate comments
including those that contain obscene,
indecent, or profane language; that
contain threats or defamatory
statements; that contain hate speech
directed at race, color, sex, national
origin, age, religion, disability, or
genetic information; or that promote or
endorse services or products. All
comments received, including any
personal information provided, also will
be available for public inspection during
normal business hours by appointment
only at the EEOC Headquarters Library,
131 M Street NE., Washington, DC
20507. Upon request, individuals who
require assistance viewing comments
will be provided appropriate aids such
as readers or print magnifiers. To
schedule an appointment, contact EEOC
Library staff at (202) 663–4630 (voice) or
(202) 663–4641 (TTY). (These are not
toll-free numbers.)
FOR FURTHER INFORMATION CONTACT:
Jamie Price, Federal Sector Programs,
Office of Federal Operations, 131 M
Street NE., Washington, DC 20507, (202)
663–4484 (voice); (202) 663–4593
(TTY).
SUPPLEMENTARY INFORMATION: The
EEOC’s Demographic Information on
Federal Job Applicants form (OMB No.
3046–0046) is intended for use by
federal agencies in gathering data on the
race, ethnicity, sex, and disability status
of job applicants. This form is used by
the EEOC and other agencies to gauge
progress and trends over time with
respect to equal employment
opportunity goals.
Pursuant to the Paperwork Reduction
Act of 1995, 44 U.S.C. Chapter 35, and

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OMB regulation 5 CFR 1320.8(d)(1), the
Commission sought public comment on
extending its form without change
through a 60-day notice published
October 20, 2016. Comments were
invited on whether this collection
would continue to enable it to:
(1) Evaluate whether the proposed
data collection tool will have practical
utility by enabling a federal agency to
determine whether recruitment
activities are effectively reaching all
segments of the relevant labor pool in
compliance with the laws enforced by
the Commission and whether the
agency’s selection procedures allow all
applicants to compete on a level playing
field regardless of race, national origin,
sex or disability status;
(2) Evaluate the accuracy of the
agency’s estimate of the burden of the
proposed collection of information,
including the validity of the
methodology and assumptions used;
(3) Enhance the quality, utility, and
clarity of the information to be
collected; and
(4) Minimize the burden of the
collection of information on applicants
for federal employees who choose to
respond, including through the use of
appropriate automated, electronic,
mechanical, or other technological
collection techniques or other forms of
information technology, e.g., permitting
electronic submission of responses.
One comment was received. The
commenter was concerned that there is
a severe under reporting in the federal
government because both OPM’s ‘‘Self
Identification of Disability’’ SF256 Form
and the ‘‘Demographic Information on
Federal Job Applicants’’ form fail to
consider the individual’s privacy. The
commenter believes that anonymous
collection of this data would result in a
more accurate representation for all
groups.
With respect to the Demographic
Information on Federal Job Applicants
form, EEOC believes that anonymity is
addressed, as the form states in its first
paragraph that it is not placed in the
individual’s personnel file or forwarded
to the panel rating the applications, the
selecting official, or anyone else that can
affect the application. EEOC cannot
address the comment as it relates to
OPM’s Form 256.
Overview of This Information
Collection
Collection Title: Demographic
Information on Federal Job Applicants.
OMB Control No.: 3046–0046.
Description of Affected Public:
Individuals submitting applications for
federal employment.
Number of Annual Responses: 5,800.

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Federal Register / Vol. 82, No. 39 / Wednesday, March 1, 2017 / Notices
Estimated Time per Response: 3
minutes.
Total Annual Burden Hours: 290.1
Annual Federal Cost: None.
Abstract: Under section 717 of Title
VII and 501 of the Rehabilitation Act,
the Commission is charged with
reviewing and approving federal
agencies plans to affirmatively address
potential discrimination before it
occurs. Pursuant to such oversight
responsibilities, the Commission has
established systems to monitor
compliance with Title VII and the
Rehabilitation Act by requiring federal
agencies to evaluate their employment
practices through the collection and
analysis of data on the race, national
origin, sex and disability status of
applicants for both permanent and
temporary employment.
Several federal agencies (or
components of such agencies) have

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1 This total is calculated as follows: 5,800 annual
responses × 3 minutes per response = 17,400
minutes. 17,400/60 = 290 hours.

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previously obtained separate OMB
approval for the use of forms collecting
data on the race, national origin, sex,
and disability status of applicants. In
order to avoid unnecessary duplication
of effort and a proliferation of forms, the
EEOC seeks an extension of the
approval of a common form to be used
by all federal agencies.
Response by applicants is optional.
The information obtained will be used
by federal agencies only for evaluating
whether an agency’s recruitment
activities are effectively reaching all
segments of the relevant labor pool and
whether the agency’s selection
procedures allow all applicants to
compete on a level playing field
regardless of race, national origin, sex,
or disability status. The voluntary
responses are treated in a highly
confidential manner and play no part in
the job selection process. The
information is not provided to any panel
rating the applications, to selecting
officials, to anyone who can affect the

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application, or to the public. Rather, the
information is used in summary form to
determine trends over many selections
within a given occupational or
organization area. No information from
the form is entered into an official
personnel file.
Burden Statement: Because of the
predominant use of online application
systems, which require only pointing
and clicking on the selected responses,
and because the form requests only
eight questions regarding basic
information, the EEOC estimates that an
applicant can complete the form in
approximately 3 minutes or less. Based
on past experience, we expect that 5,800
applicants will choose to complete the
form.
Dated: February 23, 2017.
For the Commission.
Victoria A. Lipnic,
Acting Chair.
BILLING CODE 6570–01–P

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12222

Federal Register / Vol. 82, No. 39 / Wednesday, March 1, 2017 / Notices

DEMOGRAPHIC INFORMATION ON APPLICANTS

OMB No.:
Expiration Date:

Vacancy Announcement No.:
Position Title:

YOUR PRIVACY IS PROTECTED
This information is used to determine if our equal employment opportunity efforts are reaching all segments of the population,
consistent with Federal equal employment opportunity laws. Responses to these questions are voluntary. Your responses
will not be shown to the panel rating the applications, to the official selecting an applicant for a position, or to anyone else who
can affect your application. This form will not be placed in your Personnel file nor will it be provided to your supervisors in
your employing office should you be hired. The aggregate information collected through this form will be kept private to the
extent permitted by law. See the Privacy Act Statement below for more information.
Completion of this form is voluntary. No individual personnel selections are made based on this information. There will be no
impact on your application if you choose not to answer any of these questions.

Thank you for helping us to provide better service.
1.

How did you learn about this position? (Check One):
D
D

o
o
D
D

o
D
D
D

u
o

Agency Internet Site recruitment
Private Employment Web Site
Other Internet Site
Job Fair
Newspaper or magazine
Agency or other Federal government on campus
School or college counselor or other official
Friend or relative working for this agency
Private Employment Office
Agency Human Resources Department (bulletin board or other announcement)
Federal, State, or Local Job Information Center
Other

2. Sex (Check One):
o
o

Male
Female

3. Ethnicity (Check One):

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o

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Hispanic or Latino- a person of Cuban, Mexican, Puerto Rican, South or Central American, or other
Spanish culture or origin, regardless of race.
Not Hispanic or Latino

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D

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4. Race (Check all that apply):
D
D

D
D

D

American Indian or Alaska Native- a person having origins in any of the original peoples of North or
South America (including Central America), and who maintains tribal affiliation or community attachment.
Asian - a person having origins in any of the original peoples of the Far East, Southeast Asia, or the
Indian subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan,
the Philippine Islands, Thailand, or Vietnam.
Black or African American - a person having origins in any of the black racial groups of Africa.
Native Hawaiian or Other Pacific Islander- a person having origins in any of the original peoples of
Hawaii, Guam, Samoa, or other Pacific islands.
White- a person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

5. Disability/Serious Health Condition
The next questions address disability and serious health conditions. Your responses will ensure that
our outreach and recruitment policies are reaching a wide range of individuals with physical or mental
conditions. Consider your answers without the use of medication and aids (except eyeglasses) or the
help of another person.
A.
o
o
u

o
o
o
o

o
o
o
o
o
u

Do you have any of the following? Check all boxes that apply to you:
Deaf or serious difficulty hearing
Blind or serious difficulty seeing even when wearing glasses
Missing an arm, leg, hand, or foot
Paralysis: Partial or complete paralysis (any cause)
Significant Disfigurement: for example, severe disfigurements caused by burns, wounds,
accidents, or congenital disorders
Significant Mobility Impairment: for example, uses a wheelchair, scooter, walker or uses a leg
brace to walk
Significant Psychiatric Disorder: for example, bipolar disorder, schizophrenia, PTSD, or major
depression
Intellectual Disability (formerly described as mental retardation)
Developmental Disability: for example, cerebral palsy or autism spectrum disorder
Traumatic Brain Injury
Dwarfism
Epilepsy or other seizure disorder
Other disability or serious health condition: for example, diabetes, cancer, cardiovascular
disease, anxiety disorder, or HIV infection; a learning disability, a speech impairment, or a hearing
impairment

If you did not select one of the options above, please indicate whether.
u

o

None of the conditions listed above apply to me.
I do not wish to answer questions regarding disability/health conditions.

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If you have indicated that you have one of the above conditions, you may be eligible to apply under
Schedule A Hiring Authority. For more information, please see http://www.opm.gov/policy-dataoversight/disability-employment/hiring/#uri=Schedule-A-Hiring-Authority .

12224

Federal Register / Vol. 82, No. 39 / Wednesday, March 1, 2017 / Notices
If an applicant checks the box for "other disability or serious health condition," the applicant will be
taken to Section A.1.
A.1. Other Disability or Serious Health Condition (Optional)
You indicated that you have a disability or a serious health condition. If you are willing, please select
any of the conditions listed below that apply to you. As explained above, your responses will not be
shown to the panel rating the applications, to the selecting official, or to anyone else who can affect
your application. All responses will remain private to the extent permitted by law. See the Privacy Act
Statement below for more information.
Please check all that apply:
u

o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
u

o
o
o
o
o
o
o
o

I do not wish to specify any condition.
Alcoholism
Cancer
Cardiovascular or heart disease
Crohn's disease, irritable bowel syndrome, or other gastrointestinal impairment
Depression, anxiety disorder, or other psychological disorder
Diabetes or other metabolic disease
Difficulty seeing even when wearing glasses
Hearing impairment
History of drug addiction (but not currently using illegal drugs)
HIV Infection/AIDS or other immune disorder
Kidney dysfunction: for example, requires dialysis
Learning disabilities or ADHD
Liver disease: for example, hepatitis or cirrhosis
Lupus, fibromyalgia, rheumatoid arthritis, or other autoimmune disorder
Morbid obesity
Nervous system disorder: for example, migraine headaches, Parkinson's disease, or multiple
sclerosis
Non-paralytic orthopedic impairments: for example, chronic pain, stiffness, weakness in bones or
joints, or some loss of ability to use parts of the body
Orthopedic impairments or osteo-arthritis
Pulmonary or respiratory impairment: for example, asthma, chronic bronchitis, or TB
Sickle cell anemia, hemophilia, or other blood disease
Speech impairment
Spinal abnormalities: for example, spina bifida or scoliosis
Thyroid dysfunction or other endocrine disorder
Other. Please identify the disability/health condition, if willing: _ _ __

PRIVACY ACT AND PAPERWORK REDUCTION ACT STATEMENTS

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Privacy Act Statement: This Privacy Act Statement is provided pursuant to 5 U.S.C. 552a (commonly known as the
Privacy Act of 1974). The authority for this form is 5 U.S.C. 7201, which provides that the Office of Personnel Management
shall implement a minority recruitment program, by the Uniform Guidelines on Employee Selection Procedures, 29 C.F.R.
Part 1607.4, which requires collection of demographic data to determine if a selection procedure has an unlawful disparate
impact, and by Section 501 of the Rehabilitation Act of 1973, which requires federal agencies to prepare affirmative action
plans for the hiring and advancement of people with disabilities. Data relating to an individual applicant are not provided to
selecting officials. This form will be seen by Human Resource personnel in the Office of Personnel Management (who are
not involved in considering an applicant for a particular job) and by Equal Employment Opportunity Commission officials
who will receive aggregate, non-identifiable data from the Office of Personnel Management derived from this form.
Purpose and Routine Uses: The aggregate, non-identifiable information summarizing all applicants for a position will be
used by the Office of Personnel Management and by the Equal Employment Opportunity Commission to determine if the

Federal Register / Vol. 82, No. 39 / Wednesday, March 1, 2017 / Notices

FEDERAL COMMUNICATIONS
COMMISSION
[OMB 3060–0695]
Information Collection Being Reviewed
by the Federal Communications
Commission Under Delegated
Authority

As part of its continuing effort
to reduce paperwork burdens, and as
required by the Paperwork Reduction
Act (PRA) of 1995, the Federal
Communications Commission (FCC or
Commission) invites the general public
and other Federal agencies to take this
opportunity to comment on the
following information collections.
Comments are requested concerning:
Whether the proposed collection of
information is necessary for the proper
performance of the functions of the
Commission, including whether the
information shall have practical utility;
the accuracy of the Commission’s
burden estimate; ways to enhance the
quality, utility, and clarity of the
information collected; ways to minimize
the burden of the collection of
information on the respondents,
including the use of automated
collection techniques or other forms of
information technology; and ways to
further reduce the information
collection burden on small business
concerns with fewer than 25 employees.
The FCC may not conduct or sponsor
a collection of information unless it
displays a currently valid OMB control
number. No person shall be subject to
any penalty for failing to comply with
a collection of information subject to the
PRA that does not display a valid OMB
control number.

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For
additional information about the
information collection, contact Cathy
Williams at (202) 418–2918.
SUPPLEMENTARY INFORMATION: As part of
its continuing effort to reduce
paperwork burdens, and as required by
the Paperwork Reduction Act (PRA) of
1995 (44 U.S.C. 3501–3520), the Federal
Communications Commission (FCC or
Commission) invites the general public
and other Federal agencies to take this
opportunity to comment on the
following information collections.
Comments are requested concerning:
Whether the proposed collection of
information is necessary for the proper
performance of the functions of the
Commission, including whether the
information shall have practical utility;
the accuracy of the Commission’s
burden estimate; ways to enhance the
quality, utility, and clarity of the
information collected; ways to minimize
the burden of the collection of
information on the respondents,
including the use of automated
collection techniques or other forms of
information technology; and ways to
further reduce the information
collection burden on small business
concerns with fewer than 25 employees.
OMB Control No.: 3060–0695.
Title: Section 87.219, Automatic
Operations.
Form No.: N/A.
Type of Review: Extension of a
currently approved collection.
Respondents: Business or other forprofit entities.
FOR FURTHER INFORMATION CONTACT:

Federal Communications
Commission.
ACTION: Notice and request for
comments.
AGENCY:

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Number of Respondents and
Responses: 125 respondents and 125
responses.
Estimated Time per Response: 0.7
hours.
Frequency of Response: On occasion
reporting requirement, recordkeeping
requirement, and third party disclosure
requirement.
Obligation to Respond: Required to
obtain or retain benefits. The statutory
authority for this collection of
information is contained in 47 U.S.C.
154, 303 and 307.
Total Annual Burden: 88 hours.
Annual Cost Burden: None.
Nature and Extent of Confidentiality:
There is no need for confidentiality with
this collection of information.
Privacy Act Impact Assessment: No
impact(s).
Needs and Uses: If airports have
control towers of Federal Aviation
Administration (FAA) flight service
stations and more than one licensee,
and wants to have an automated
aeronautical advisory station (Unicom),
this rule requires that they must write
an agreement and keep a copy of the
agreement with each licensee’s station
authorization. This information will be
used by compliance personnel for
enforcement purposes and by licensees
to clarify responsibility in operating
Unicom.
Federal Communications Commission.
Marlene H. Dortch,
Secretary, Office of the Secretary.
[FR Doc. 2017–03989 Filed 2–28–17; 8:45 am]
BILLING CODE 6712–01–P

FEDERAL COMMUNICATIONS
COMMISSION
[OMB 3060–0548]

Information Collection Being Reviewed
by the Federal Communications
Commission
Federal Communications
Commission.

AGENCY:

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EN01MR17.003

BILLING CODE 6570–01–C

SUMMARY:

Written PRA comments should
be submitted on or before May 1, 2017.
If you anticipate that you will be
submitting comments, but find it
difficult to do so within the period of
time allowed by this notice, you should
advise the contact listed below as soon
as possible.
ADDRESSES: Direct all PRA comments to
Cathy Williams, FCC, via email
[email protected] and to
[email protected].
DATES:

[FR Doc. 2017–03904 Filed 2–28–17; 8:45 am]

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