Required Data Elements for Paternity Establishment Affidavits

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Required and Optional Data Elements	Form and Instruction	New	Available
SUPPSTAT Vol Ack of Pat and Pat Estab Affidavit final.docx	Supporting Statement A	Uploaded 2017-05-23	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
9965	Required Data Elements for Paternity Establishment Affidavits		Removed
226978	Ordering Brochures		New
226977	Data Elements	Form and Instruction	New	Required and Optional Data Elements
226976	Training		New
226975	Paternity Acknowledgment Process		New

ICR Details

OMB Control No: 0970-0171	ICR Reference No: 201705-0970-003
Status: Historical Active	Previous ICR Reference No: 201401-0970-005
Agency/Subagency: HHS/ACF	Agency Tracking No: OCSE
Title: Required Data Elements for Paternity Establishment Affidavits
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 01/23/2018
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/24/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2021	36 Months From Approved	01/31/2018
Responses	5,343,546	0	1,113,719
Time Burden (Hours)	782,003	0	189,332
Cost Burden (Dollars)	0	0	0

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Abstract: Sections of the Social Security Act require the Secretary of Health and Human Services to specify the minimum requirements of an affidavit to be used for the voluntary establishment of paternity. The Act also requires States to enact laws requiring the development and the use of an affidavit for the voluntary acknowledgement of paternity which includes the minimum requirements of the affidavit specified by the Secretary. The information collected will be used by State birth record agencies and State IV-D offices, if needed, in child support enforcement activities.

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Authorizing Statute(s): US Code: 42 USC 666 Name of Law: Child Support
  

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 66285	09/27/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 19377	04/27/2017
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Data Elements	1	Required and Optional Data Elements
Ordering Brochures
Paternity Acknowledgment Process
Required Data Elements for Paternity Establishment Affidavits
Training

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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	5,343,546	1,113,719	0	5,343,546	-1,113,719	0
Annual Time Burden (Hours)	782,003	189,332	0	782,003	-189,332	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: Program change. In the past, OCSE submitted the Voluntary Acknowledgment of Paternity (OMB 0970-0175) and Required Data Elements for Paternity Establishment Affidavits (OMB 9070-0171) PRA requests as separate PRA packages. Since they were both related to the voluntary acknowledgment of paternity process and processed within the same PRA timeframes, OCSE decided to consolidate and submit them in one PRA package with one OMB number.

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Annual Cost to Federal Government: $30,640,264

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.     No

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: 05/24/2017

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