OMB 83-i

omb83-i.pdf

State & Local Government Finance Forms

OMB 83-I

OMB: 0607-0585

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PAPERWORK REDUCTION ACT SUBMISSION
Please read the instructions before completing this form. For additional forms or assistance in completing this form, contact your
agency's Paperwork Clearance Officer. Send two copies of this form, the collection instrument to be reviewed, the Supporting
Statement, and any additional documentation to: Office of Information and Regulatory Affairs, Office of Management and Budget,
Docket Library, Room 10102, 725 17th Street NW, Washington, DC 20503.
2. OMB CONTROL NUMBER

1. AGENCY/SUBAGENCY ORIGINATING REQUEST

Department of Commerce/Census Bureau/International Trade
Management Division

a.

0585

b. NONE

4. TYPE OF REVIEW REQUESTED (X one)

3. TYPE OF INFORMATION COLLECTION (X one)

x
a. NEW COLLECTION

x

0607

a. REGULAR SUBMISSION
b. EMERGENCY - APPROVAL REQUESTED BY:

b. REVISION OF A CURRENTLY APPROVED COLLECTION

c. DELEGATED

c. EXTENSION OF A CURRENTLY APPROVED COLLECTION
d. REINSTATEMENT, WITHOUT CHANGE, OF A PREVIOUSLY
APPROVED COLLECTION FOR WHICH APPROVAL HAS EXPIRED

5. SMALL ENTITIES
Will this information collection have a significant economic
impact on a substantial number of small entities?

e. REINSTATEMENT, WITH CHANGE, OF A PREVIOUSLY
APPROVED COLLECTION FOR WHICH APPROVAL HAS EXPIRED

YES
NO
x
6. REQUESTED EXPIRATION DATE

x

f. EXISTING COLLECTION IN USE WITHOUT AN OMB CONTROL
NUMBER

a. THREE YEARS FROM APPROVAL DATE
b. OTHER:

7. TITLE

State and Local Government Finance Forms
8. AGENCY FORM NUMBER(S) (if applicable)
F-5, F-11, F-12, F-13, F-28, F-29, F-32
9. KEYWORDS

10. ABSTRACT
This program provides government finance data for state and local governments. This survey is conducted annually, as a national census every five years, and as a
sample survey in each of the four intervening years. The Census Bureau provides these data to the Federal Reserve Board for constructing the Nation's Flow of
Funds Accounts and the Bureau of Economic Analysis for the National Income and Product Accounts. The data are also used to monitor the government sector of
the economy and to formulate, develop, and review public policy. Federal agencies, state and local governments, and the private sector all use these data. The
respondents to this survey are state and local government officials.
11. AFFECTED PUBLIC (Mark primary with "P" and all others that apply with "X")
a. INDIVIDUALS OR HOUSEHOLDS

d. FARMS

b. BUSINESS OR OTHER FOR-PROFIT

e. FEDERAL GOVERNMENT

12. OBLIGATION TO RESPOND (Mark primary with "P" and all

P

a. VOLUNTARY

others that apply with "X")

b. REQUIRED TO OBTAIN OR RETAIN BENEFITS

c. MANDATORY
P f. STATE, LOCAL OR TRIBAL GOVERNMENT
13. ANNUAL REPORTING AND RECORDKEEPING HOUR BURDEN
14. ANNUALIZED COST TO RESPONDENTS (In thousands of dollars)
c. NOT-FOR-PROFIT INSTITUTIONS

a. NUMBER OF RESPONDENTS
b. TOTAL ANNUAL RESPONSES
(1) Percentage of these responses collected electronically
c. TOTAL ANNUAL HOURS REQUESTED
d. CURRENT OMB INVENTORY
e. DIFFERENCE (+, -)
f.

EXPLANATION OF
DIFFERENCE:

(1) Program change (+, -)

26,447
26,447
99
75,150
36,377
38,773
38,773

a. TOTAL CAPITAL/STARTUP COSTS
c. TOTAL ANNUALIZED COST REQUESTED
d. CURRENT OMB INVENTORY
e. DIFFERENCE (+, -)
f.

(2) Adustment (+, -)

15. PURPOSE OF INFORMATION COLLECTION (Mark primary with

16. FREQUENCY OF RECORDKEEPING OR REPORTING (X all that apply)

"P" and all others that apply with "X")

c. GENERAL PURPOSE STATISTICS
d. AUDIT

17. STATISTICAL METHODS
Does this information collection employ
statistical methods?
X

YES

OMB FORM 83-I, 10/95

a. RECORDKEEPING
e. PROGRAM PLANNING
OR MANAGEMENT

b. PROGRAM EVALUATION

P

NO

EXPLANATION OF DIFFERENCE:
(1) Program change (+, -)

(2) Adustment (+, -)

a. APPLICATION FOR BENEFITS

0.00

b. TOTAL ANNUAL COSTS (O&M)

f. RESEARCH
g. REGULATORY OR
COMPLIANCE

X

b. THIRD PARTY DISCLOSURE

c. REPORTING:
(1) On Occasion

(2) Weekly

(4) Quarterly

(5) Semi-Annually

(7) Biennially

(8) Other (Describe)

(3) Monthly

X

(6) Annually

18. AGENCY CONTACT (Person who can best answer questions regarding the content of this
submission)
a. NAME

Randy Moore

b. TELEPHONE NUMBER (Include area code)

301-763-7231

OMB CONTROL NUMBER

0607

0585

TITLE

State and Local Government Finance Forms

19. CERTIFICATION FOR PAPERWORK REDUCTION ACT SUBMISSIONS
a. PROGRAM OFFICIAL CERTIFICATION (Internal DOC Use Only)
Type name

Date

John Thompson, Director U.S. Census Bureau

On behalf of this Federal agency, I certify that the collection of information encompassed by this request
complies with 5 CFR 1320.9.
NOTE: The text of 5 CFR 1320.9, and the related provisions of 5 CFR 1320.8(b)(3), appear at the end of the
instructions. The certification is to be made with reference to those regulatory provisions as set forth in the
instructions.
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 (see note in Item 19 of the instructions);
(i) If applicable, it uses effective and efficient statistical survey methodology; and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item below and explain the
reason in Item 18 of the Supporting Statement.

b. SENIOR OFFICIAL OR DESIGNEE CERTIFICATION
Type name

Jennifer Jessup, Departmental Paperwork Clearance Officer
OMB FORM 83-I (BACK), 10/95

Date


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File TitleKM_654e-20170417081321
File Modified2017-04-17
File Created2017-04-17

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