Digital Inclusion Corps Pilot Project Evaluation

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Digital Inclusion Digital Inclusion PrePost End of Project Surveys	Form and Instruction	New	Available
3117 Invite Appendix B Letter of Invitation and Reminder Communications FINAL.pdf	Supplementary Document	Uploaded 2017-07-03	Available
Burden Estimates -- Digital_Inclusion_Corps_Evaluation_FINAL_2.xlsx	Supplementary Document	Uploaded 2017-07-03	Available
Digital Inclusion Corps Pilot Project Section B --FINAL.pdf	Supporting Statement B	Uploaded 2017-07-03	Available
Digital Inclusion Corps Pilot Project Section A --FINAL.pdf	Supporting Statement A	Uploaded 2017-07-03	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
227369	Digital Inclusion PrePost End of Project Surveys	Form and Instruction	New

ICR Details

OMB Control No: 3137-0109	ICR Reference No: 201707-3137-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: IMLS	Agency Tracking No:
Title: Digital Inclusion Corps Pilot Project Evaluation
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/14/2017
	Date Received in OIRA: 07/03/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2020	36 Months From Approved
Responses	30	0	0
Time Burden (Hours)	18	0	0
Cost Burden (Dollars)	509	0	0

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Abstract: An information collection to help evaluate the Digital Inclusion Corps Pilot project in meeting its project goals through the use of four performance measures. The survey instrument will be administered pre-and post-project implementation. Total impact per respondent is not more than 1 hour total (30 mins for not-for-profit respondents; 55 mins for state library agency or museum organization respondents).

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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:
	82 FR 2	01/04/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 126	07/03/2017
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Digital Inclusion PrePost End of Project Surveys	Digital Inclusion Pilot Project Form 1	Digital Inclusion Pilot Project Survey

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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	30	0	0	30	0	0
Annual Time Burden (Hours)	18	0	0	18	0	0
Annual Cost Burden (Dollars)	509	0	0	509	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: No burden increase. New collection.

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Annual Cost to Federal Government: $32,798

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: 07/03/2017

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