Rap Back Services Form (1-796)

Forms and Documents

Document Name	Status
Form 1-796 Rap Back Services Form 1-796 Form and Instruction	Modified
1-796 MOU.pdf Supplementary Document	2018-10-30
1-796 Law.pdf Supplementary Document	2018-10-30
Updated Rap Back 83I (Fillable).pdf Supplementary Document	2018-10-31
1-796 Certification.pdf Supplementary Document	2018-10-30
Supporting Statement A.docx Supporting Statement A	2018-10-31

IC Document Collections

IC ID	Document Title	Status
215135	Rap Back Services Form 1-796 Form and Instruction	Modified

ICR Details

OMB Control No: 1110-0067	ICR Reference No: 201710-1110-006
Status: Active	Previous ICR Reference No: 201502-1110-004
Agency/Subagency: DOJ/FBI	Agency Tracking No:
Title: Rap Back Services Form (1-796)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/31/2019
	Date Received in OIRA: 10/31/2018
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2022	36 Months From Approved	02/28/2019
Responses	12	0	6,000
Time Burden (Hours)	1	0	300
Cost Burden (Dollars)	0	0	0

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Abstract: DOJ's CJIS is requesting approval for a currently approved collection utilized by authorized agencies to enroll individuals in the Rap Back Service to ensure the submitting agency is notified when individuals in positions of trust engage in criminal conduct or individuals under the supervision of a criminal justice agency commit subsequent criminal acts.

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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:
	83 FR 40568	08/15/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 51707	10/12/2018
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
Rap Back Services Form 1-796	1-796	Rap Back Services Form

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ICR Summary 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	12	6,000	0	-5,988	0	0
Annual Time Burden (Hours)	1	300	0	-299	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: When the form was created 3 years ago, we provided estimates as we did not have any customers on board. The form was created because we are required to have a manual process to match any electronic process which we have. However, to be a Rap Back participant an agency must be 10.0EBTS compliant. To date, no one has utilized this form. We do not anticipate the utilization of this form in the future. The number of respondents was changed to reflect current and pending Rap Back participants.

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Annual Cost to Federal Government: $0

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.     Yes

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.     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: 10/31/2018

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